Evelyn Monique Harris, BA, LSST

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

6309 Mack Ave
Detroit, MI 48207-2302

Phone

(313) 269-9158

NPI assigned

Feb 28, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1881340867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6309 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072302",
            "telephone_number": "313-269-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6309 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072302",
            "telephone_number": "313-269-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "EVELYN",
        "middle_name": "MONIQUE",
        "credential": "BA, LSST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "teamwellness.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6309 Mack Ave",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482072302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "teamwellness.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6309 Mack Ave",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482072302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Donyae Tamir Harris
• Dwight Harris, CPSS
• Ebony Diane Harris, NONE
• Erica Harris
• Erika Harris
• Herbert Harris Sr.
• Ira Harris
• Jaylin Martel Harris
• Johan Elliott Harris, MD
• Jordan Harris

• Clinical Social Worker in Detroit, MI
• Providers in Detroit, 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 Feb 28, 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.