Individual provider Active NPI

Elizabeth Harris

  • Clinical Social Worker
  • Watertown, MA
National Provider Identifier
1649525486
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
121528 Issued in MA
Practice address
40 Spring St Ste 215
Watertown, MA 02472
Phone
(508) 740-0168
NPI assigned
Jul 18, 2012
Last updated
Aug 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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 71286 CA
Clinical Social Worker 1041C0700X 121528 MA Primary

Addresses

Primary practice location

40 Spring St Ste 215
Watertown, MA 02472

Mailing address

40 Spring St Ste 215
Watertown, MA 02472-3474
Phone (508) 740-0168

Other practice location 1

206 S California Ave
Palo Alto, CA 94306-1618
Phone (650) 617-8340 ext. 3343

Other practice location 2

206 S California Ave
Palo Alto, CA 94306-1618
Phone (650) 617-8340 ext. 3343

Other names 1

  • Betsy Harris Other name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
121528MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1649525486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 SPRING ST STE 215",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024723474",
            "telephone_number": "508-740-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SPRING ST STE 215",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "02472",
            "telephone_number": "508-740-0168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 S California Ave",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943061618",
            "country_code": "US",
            "telephone_number": "650-617-8340 x3343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 S California Ave",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943061618",
            "country_code": "US",
            "telephone_number": "650-617-8340 x3343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "71286",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "121528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETSY",
            "last_name": "HARRIS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Watertown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.