Individual provider Active NPI

Onya Harris, LCSW

  • Clinical Social Worker
  • Woodbridge, CT
National Provider Identifier
1700209079
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004490 Issued in CT
Practice address
21 Hazel Ter
Suite 4
Woodbridge, CT 06525-2209
Phone
(203) 389-7306
Fax
(203) 389-7307
NPI assigned
Jan 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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 004490 CT Primary

Addresses

Primary practice location

21 Hazel Ter
Suite 4
Woodbridge, CT 06525-2209

Mailing address

21 Hazel Ter
Suite 4
Woodbridge, CT 06525-2209
Phone (203) 389-7306

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
004490CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1700209079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 HAZEL TER",
            "address_2": "SUITE 4",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252209",
            "telephone_number": "203-389-7306",
            "fax_number": "203-389-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HAZEL TER",
            "address_2": "SUITE 4",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252209",
            "telephone_number": "203-389-7306",
            "fax_number": "203-389-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ONYA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-22",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.