Active NPI
Philip J Harris, LCSW-A
- Clinical Social Worker
- Charlotte, NC
National Provider Identifier
1689194045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P011662
- Practice address
- 4000 Tuckaseegee Rd
Charlotte, NC 28208-2832 - Phone
- (704) 523-5775
- Fax
- (704) 629-8404
- NPI assigned
- Jun 26, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P011662 | NC | Primary |
Addresses
Primary practice location
4000 Tuckaseegee Rd
Charlotte, NC 28208-2832
Mailing address
8531 Ridgeline LN
Charlotte, NC 28269-8000
Phone (757) 581-1619
Other practice location 1
416 McCullough Dr Ste 100
Charlotte, NC 28262-4386
Phone (704) 921-9943
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689194045 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| P011662 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PJ Harris & Associates | Clinical | Past | Accepting new patients |
| Trauma Assessment & Treatment Center, PLLC | Clinical | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Social Worker
- Charlotte, NC
- NPI 1033630025
-
- Clinical Social Worker
- Charlotte, NC
- NPI 1255692919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1689194045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8531 RIDGELINE LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282698000",
"telephone_number": "757-581-1619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 TUCKASEEGEE RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282082832",
"telephone_number": "704-523-5775",
"fax_number": "704-629-8404"
}
],
"practiceLocations": [
{
"address_1": "416 McCullough Dr Ste 100",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282624386",
"country_code": "US",
"telephone_number": "704-921-9943",
"fax_number": "704-665-1959",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARRIS",
"first_name": "PHILIP",
"middle_name": "J",
"credential": "LCSW-A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-26",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P011662",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1689194045",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.