Individual provider Active NPI

Elizabeth Harry, LCSW

  • Clinical Social Worker
  • Southern Pines, NC
National Provider Identifier
1639150014
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C006021 Issued in NC
Practice address
225 W Pennsylvania Ave
Southern Pines, NC 28387-5430
Phone
(910) 986-0935
Fax
(910) 986-0935
NPI assigned
Nov 11, 2005
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I05345 NM
Clinical Social Worker 1041C0700X C006021 NC Primary

Addresses

Primary practice location

225 W Pennsylvania Ave
Southern Pines, NC 28387-5430

Mailing address

225 W Pennsylvania Ave
Southern Pines, NC 28387-5430
Phone (910) 986-0935

Other practice location 1

35 Memorial Dr
Pinehurst, NC 28374-8708
Phone (910) 715-3376

Other identifiers 1

IdentifierTypeStateIssuer
41284755MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080920000020 NC Practitioner - Clinical Social Worker 5395812101 Reassigns benefits to 1 organization
Practice locations: Pinehurst, NC; Southern Pines, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

225 W Pennsylvania Ave
Southern Pines, NC 28387-5430
Phone (910) 986-0935

35 Memorial Dr
Pinehurst, NC 28374-8708
Phone (910) 715-3263

Merit-based Incentive Payment System (MIPS)

Final score
98.64 of 100Reported as group
Quality
94.98
Promoting interoperability
86
Improvement activities
40
Cost
94.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I05345NMMDClinical Social Worker

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1639150014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W PENNSYLVANIA AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875430",
            "telephone_number": "910-986-0935",
            "fax_number": "910-715-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W PENNSYLVANIA AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875430",
            "telephone_number": "910-986-0935",
            "fax_number": "910-986-0935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Pinehurst",
            "state": "NC",
            "postal_code": "283748708",
            "country_code": "US",
            "telephone_number": "910-715-3376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRY",
        "first_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-11",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I05345",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41284755",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southern Pines, NC

Sources for this page

Verify at the official NPI Registry.