Individual provider Active NPI

Regine D Harris, LCSW, LCASA

  • Mental Health Counselor
  • Fayetteville, NC
National Provider Identifier
1750057378
Registry record updated Aug 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C020438 Issued in NC
Practice address
1724 Roxie Ave
Fayetteville, NC 28304-1623
Phone
(910) 778-5900
Fax
(919) 758-9317
NPI assigned
Aug 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C020438 NC Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-27646 NC

Addresses

Primary practice location

1724 Roxie Ave
Fayetteville, NC 28304-1623

Mailing address

11361 N 99TH Ave Ste 402
Peoria, AZ 85345-5459
Phone (602) 650-1212

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P016605NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787356800000",
    "number": "1750057378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11361 N 99TH AVE STE 402",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853455459",
            "telephone_number": "602-650-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 ROXIE AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283041623",
            "telephone_number": "910-778-5900",
            "fax_number": "919-758-9317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "REGINE",
        "middle_name": "D",
        "credential": "LCSW, LCASA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2026-08-22",
        "certification_date": "2026-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C020438",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-27646",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.