Malissa Bobbi Harris, LCSW, MSW, CMC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW20130 Issued in FL

Practice address

69540 Campground Rd
Bruce TWP, MI 48065-4317

Phone

(586) 292-1221

NPI assigned

Mar 15, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pines to Palms, LLC

  • Clinical Social Worker
  • Rochester, MI
  • NPI 1578412458
  NPD Authorized official

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1851976526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54",
            "city": "ROMEO",
            "state": "MI",
            "postal_code": "480650054",
            "telephone_number": "727-601-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69540 CAMPGROUND RD",
            "city": "BRUCE TWP",
            "state": "MI",
            "postal_code": "480654317",
            "telephone_number": "586-292-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MALISSA",
        "middle_name": "BOBBI",
        "credential": "LCSW, MSW, CMC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-15",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERICAL",
            "identifier": "1851976526",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "malissa.harris@pinestopalmsgcm.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11373 67th Ave",
            "city": "Seminole",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337726211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Digital Echo Enterprises
• Patricia Brookie Farr
• Hilda C. Ferrarer-Blair, M.D.
• Cynthia Fulkerth
• Farrah Hafeez, D.O
• Susan Hengel, LMT
• Henry Ford Macomb Hospital Corporation (Henry Ford Macomb Health Centers-Bruce TWP/Chesterfield/Fraser)
• Alan J Hoyer, MD
• James L. Ziobron DO PC (Romeo Preventative Medicine)
• Nancy J Joye, M.A., L.P.C., CAADC

• Clinical Social Worker in Bruce TWP, MI
• Providers in Bruce TWP, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.