Deitra Harris, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C010735 Issued in NC

Practice address

7700 Ella Jane LN Apt W
Charlotte, NC 28273-4782

Phone

(704) 200-7983

NPI assigned

Oct 5, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Deitra Harris Professional name

Medicare fee-for-service enrollment

Enrolled in NC, SC, DC, CT, MA5 enrollments

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 5

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, CT, DC, MA, NC, SC

  Medicare reassignment NPD
• Sondermind PC

  • Clinical Social Worker
  • San Jose, CA
  • NPI 1003646977

  NC

  Medicare reassignment NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  CT, SC

  Medicare reassignment NPD
• Evolution You, PLLC

  • Adult Mental Health Clinic/Center
  • Charlotte, NC
  • NPI 1225647811
  NPD Authorized official

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1679048623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 ELLA JANE LN APT W",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282734782",
            "telephone_number": "704-200-7983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 ELLA JANE LN APT W",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282734782",
            "telephone_number": "704-200-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "DEITRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-05",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEITRA",
            "last_name": "HARRIS",
            "credential": "LISW-CP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Chastin Lamont Harris
• Chrissy Latonya Harris, AGACNP
• Christopher Travis Harris, D.D.S., M.S.
• Cierra Harris
• Courtney Denise Harris, LCSWA
• Deleeah Harris
• Delton Harris
• Dusty Christopher Harris, NP
• Dwayne Harris, LPCA
• Edward Flynn Harris, DDS

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.