Active NPI
Carol Sue Harris, LICSW
- Clinical Social Worker
- Brighton, MA
National Provider Identifier
1780785840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 105567
- Practice address
- 77 Warren St
Building 2
Brighton, MA 02135-3601 - Phone
- (617) 787-4662
- Fax
- (617) 787-4662
- NPI assigned
- Sep 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 105567 | MA | Primary |
Addresses
Primary practice location
77 Warren St
Building 2
Brighton, MA 02135-3601
Mailing address
77 Warren St
Building 2 3Rd Floor
Brighton, MA 02135-3601
Phone (617) 787-4662
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 147511000 | Other | MA | HMO/MAGELLAN |
| 008625 | Other | MA | PACIFICARE |
| 602105 | Other | MA | TUFTS |
| P06741 | Other | MA | BLUE CROSS BLUE SHIELD |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242777600000",
"number": "1780785840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 WARREN ST",
"address_2": "BUILDING 2 3RD FLOOR",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021353601",
"telephone_number": "617-787-4662",
"fax_number": "617-787-4662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 WARREN ST",
"address_2": "BUILDING 2",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021353601",
"telephone_number": "617-787-4662",
"fax_number": "617-787-4662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "CAROL",
"middle_name": "SUE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-25",
"last_updated": "2009-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "105567",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMO/MAGELLAN",
"identifier": "147511000",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFICARE",
"identifier": "008625",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "602105",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "P06741",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brighton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.