Individual provider Active NPI

K C Harrison, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1770094716
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12660-C Issued in NV
Practice address
5576 S Fort Apache Rd Ste 120
Las Vegas, NV 89148-3607
Phone
(702) 646-5437
NPI assigned
Oct 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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 12660-C NV Primary

Addresses

Primary practice location

5576 S Fort Apache Rd Ste 120
Las Vegas, NV 89148-3607

Mailing address

8760 W Patrick LN Unit 2085
Las Vegas, NV 89148-5312
Phone (702) 201-6007

Other practice location 1

2300 W Sahara Ave Ste 800
Las Vegas, NV 89102-4397
Phone (646) 941-7645

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
12660-CNVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1770094716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8760 W PATRICK LN UNIT 2085",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485312",
            "telephone_number": "702-201-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5576 S FORT APACHE RD STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891483607",
            "telephone_number": "702-646-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 W Sahara Ave Ste 800",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891024397",
            "country_code": "US",
            "telephone_number": "646-941-7645",
            "fax_number": "929-596-7897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "K C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-17",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "12660-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; 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.