Liza Haroldson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6873 Issued in TN

Practice address

1820 Memorial Dr
Clarksville, TN 37043-6326

Phone

(217) 649-9553

NPI assigned

Mar 25, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Liza Masar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1619219904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 MEMORIAL DR STE 203",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434693",
            "telephone_number": "217-649-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 MEMORIAL DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436326",
            "telephone_number": "217-649-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAROLDSON",
        "first_name": "LIZA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-25",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8019",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K400192662",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619219904",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100043360",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIZA",
            "last_name": "MASAR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristen Michelle Hardin, M.S., CCC-SLP
• La'Tasha Yvonne Hardy, L.P.N,
• Lauren Grace Hardy, PA-C
• Rondell Harju, LCSW
• Bethany King Harman
• Ayman Haroun, DMD
• Tracie Lynn Harp, B.S.
• Ashley Harper
• Lindsey Harper
• Ralph Carney Harper, DDS

• Clinical Social Worker in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.