Individual provider Active NPI

John R Haram, LICSW

  • Clinical Social Worker
  • Martinsburg, WV
National Provider Identifier
1790749505
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CP00450559 Issued in WV
Practice address
420 Randolph St
Martinsburg, WV 25401-2888
Phone
(304) 263-2220
Fax
(304) 264-1531
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CP00450559 WV Primary
Clinical Social Worker 1041C0700X V00308 VA

Addresses

Primary practice location

420 Randolph St
Martinsburg, WV 25401-2888

Mailing address

52 Goshen LN
Martinsburg, WV 25404-1324
Phone (304) 263-2220

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

State licenses

LicenseStateTypeSpecialty
V00308VAMDClinical Social Worker
CP00450559WVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
GMS Medical Eye Center, LLC Past Accepting new patients

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1790749505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 GOSHEN LN",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254041324",
            "telephone_number": "304-263-2220",
            "fax_number": "304-264-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 RANDOLPH ST",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012888",
            "telephone_number": "304-263-2220",
            "fax_number": "304-264-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARAM",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "CP00450559",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "V00308",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.