Individual provider Active NPI

Kimberly Jean Harrison, CSAC

  • Addiction (Substance Use Disorder) Counselor
  • Raleigh, NC
National Provider Identifier
1760725378
Registry record updated Apr 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2750 Issued in NC
Practice address
211 E Six Forks Rd
Suite 117
Raleigh, NC 27609-7745
Phone
(919) 833-8899
Fax
(919) 933-8894
NPI assigned
Apr 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2750 NC Primary

Addresses

Primary practice location

211 E Six Forks Rd
Suite 117
Raleigh, NC 27609-7745

Mailing address

211 E Six Forks Rd
Suite 117
Raleigh, NC 27609-7745
Phone (919) 833-8899

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

LicenseStateTypeSpecialty
2750NCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364860800000",
    "number": "1760725378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E SIX FORKS RD",
            "address_2": "SUITE 117",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097745",
            "telephone_number": "919-833-8899",
            "fax_number": "919-933-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E SIX FORKS RD",
            "address_2": "SUITE 117",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097745",
            "telephone_number": "919-833-8899",
            "fax_number": "919-933-8894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "KIMBERLY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-02",
        "last_updated": "2013-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "2750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.