Individual provider Active NPI

Malissa Marie Harris, LCSW

  • Clinical Social Worker
  • Granbury, TX
National Provider Identifier
1619874880
Registry record updated Oct 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110786 Issued in TX
Practice address
104 Pirate Dr
Granbury, TX 76048-5682
Phone
(940) 463-7219
NPI assigned
Oct 21, 2026
Last updated
Oct 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 110786 TX Primary

Addresses

Primary practice location

104 Pirate Dr
Granbury, TX 76048-5682

Mailing address

1330 River Hills Rd
Stephenville, TX 76401-8050
Phone (575) 302-4513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1792540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792540800000",
    "number": "1619874880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 RIVER HILLS RD",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764018050",
            "telephone_number": "575-302-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 PIRATE DR",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485682",
            "telephone_number": "940-463-7219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MALISSA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-21",
        "last_updated": "2026-10-21",
        "certification_date": "2026-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "110786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.