Individual provider Active NPI

Tiquicha Monique Harris, MSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1790916609
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1900 The Exchange SE
Suite 420
Atlanta, GA 30339-2022
Phone
(678) 460-0345
Fax
(678) 460-0350
NPI assigned
Jul 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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 Primary
Social Worker 104100000X MSW004830 GA

Addresses

Primary practice location

1900 The Exchange SE
Suite 420
Atlanta, GA 30339-2022

Mailing address

1425 Market Blvd Ste 530-145
Roswell, GA 30076-6708
Phone (678) 852-2987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240322000593 GA Practitioner - Clinical Social Worker 7416394721 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1843 Peeler Rd
Suite C
Dunwoody, GA 30338-5706
Phone (678) 852-2987

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MSW004830GAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Capstone Hospice, LLC CurrentSince Feb 27, 2024 Accepting new patients
Unlock Dreams Social Worker CurrentSince Jul 4, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince Aug 1, 2025 Accepting new patients

Locations

3424 Peachtree Rd NE
Ste 2200
Atlanta, GA 30326
Phone (404) 436-2563

1843 Peeler Rd
Ste C
Dunwoody, GA 30338
Phone (330) 486-5356

5550 Peachtree Pkwy
Ste 150
Peachtree Corners, GA 30092
Phone (770) 558-6202

1425 Market Blvd
Ste 530145
Roswell, GA 30076

Organizations & group practices 3

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": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1790916609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 MARKET BLVD STE 530-145",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300766708",
            "telephone_number": "678-852-2987",
            "fax_number": "888-375-4037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 THE EXCHANGE SE",
            "address_2": "SUITE 420",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392022",
            "telephone_number": "678-460-0345",
            "fax_number": "678-460-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TIQUICHA",
        "middle_name": "MONIQUE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW004830",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.