Stacie Nicole Harrison, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R157930 Issued in MD

Practice address

7822 Eastern Ave
Baltimore, MD 21224-2115

Phone

(800) 847-6028

NPI assigned

May 24, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mahogany Wellness

  • Psychiatry Physician
  • Baltimore, MD
  • NPI 1073207171
  Medicare reassignment NPD Authorized official
• Tidemark Intervention Services

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1720595242
  Medicare reassignment NPD
• Tidemark Intervention Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1174235691
  NPD

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1811280803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 BAYONNE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212142323",
            "telephone_number": "410-426-1327",
            "fax_number": "410-426-1327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7822 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242115",
            "telephone_number": "800-847-6028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3108 Bayonne Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212142323",
            "country_code": "US",
            "telephone_number": "410-426-1327",
            "fax_number": "410-426-1327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "STACIE",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-24",
        "last_updated": "2023-05-05",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R157930",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R157930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miles Harrison, M.D.
• Nyja Harrison
• Paige Elizabeth Harrison, D.O.
• Sabrina Harrison, DPT
• Stacey Harrison, LCPC
• Charissa Harriston
• Mia Rae Harron
• Cheryl Ann Harrow, MS, APRN
• Ilana Shira Harrow, LGPC, NCC
• Jeffrey Harrow, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.