Theresa Anne Harris

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2014008536 Issued in MO

Practice address

760 Plantation Blvd
Sikeston, MO 63801-5736

Phone

(573) 748-0806

NPI assigned

Aug 10, 2021

Last updated

Aug 10, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bootheel Counseling Services

  • Community/Behavioral Health Agency
  • Sikeston, MO
  • NPI 1700652898
  NPD (past)

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1972278117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 SAINT PAUL DR",
            "city": "NEW MADRID",
            "state": "MO",
            "postal_code": "638691315",
            "telephone_number": "573-748-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 PLANTATION BLVD",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015736",
            "telephone_number": "573-748-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "THERESA",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2014008536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeff Michael Hardin, RRT
• Tiffany Brooke Hardin, FNP-C
• Lauren Nicole Hardy, PA-C
• Brenda J. Harper, PTA
• Micah Dale Harris, LCSW
• Jeffrey Harrison, D.C.
• Syed K Hashmi, MD
• Brittany Ann Hawkins, APRN
• Jackie G Hay
• Taylor Anne Haynes

• Clinical Social Worker in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.