Charles Macloren Harris, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

254440 Issued in KY

Practice address

830 Chalkstone Ave
Providence VA Medical Center
Providence, RI 02908-4734

Phone

(401) 459-4700

NPI assigned

Mar 22, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

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.

• Trigg County Hospital, Inc

  • Critical Access Hospital
  • Cadiz, KY
  • NPI 1538218680

  Clinical

  Medicare reassignment NPD
• Trigg County Hospital, Inc

  • Rural Health Clinic/Center
  • Cadiz, KY
  • NPI 1669103347
  NPD

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1740589373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 COUNTRY CLUB LN",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422403865",
            "telephone_number": "775-843-5807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 CHALKSTONE AVE",
            "address_2": "PROVIDENCE VA MEDICAL CENTER",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084734",
            "telephone_number": "401-459-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CHARLES",
        "middle_name": "MACLOREN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-22",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091712",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "254440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Harrington, LICSW
• Katelyn Maeve Harrington, PA
• Meghan Harrington, MD
• Thomas Ryan Harrington
• Annette Marie Harris, MSW, LICSW
• Christy Harris, LICSW
• Daniel E Harris
• Jeffery Harris, LEAD INSPECTOR
• Laura Harris, BA, CADC, LPRS, LCDP
• Madison Harris, LMHC-A

• Clinical Social Worker in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.