Individual provider Active NPI

Shaya Leigh Harris

  • Social Worker
  • Shawnee, OK
National Provider Identifier
1790346641
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6829-P Issued in OK
Practice address
101 N Union Ave
Shawnee, OK 74801-7067
Phone
(405) 214-4700
NPI assigned
Jun 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6829-P OK Primary

Addresses

Primary practice location

101 N Union Ave
Shawnee, OK 74801-7067

Mailing address

101 N Union Ave
Shawnee, OK 74801-7067
Phone (405) 214-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20221205000804 OK Practitioner - Clinical Social Worker 7315316981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

214 N Oklahoma Ave
Shawnee, OK 74801-7030
Phone (405) 481-0447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6829-POKMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brickhouse Therapy Solutions, LLC CurrentSince May 5, 2023 Accepting new patients

Locations

214 N Oklahoma Ave
Shawnee, OK 74801
Phone (405) 481-0447

602 N Broadway St
Tecumseh, OK 74873
Phone (405) 296-3334

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1790346641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N UNION AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748017067",
            "telephone_number": "405-214-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N UNION AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748017067",
            "telephone_number": "405-214-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "SHAYA",
        "middle_name": "LEIGH",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-21",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OK",
            "license": "6829-P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

Verify at the official NPI Registry.