| Mrs Beverly Dawn Harris, MSW, PLCSW | |
|
2715 E Logan St, Republic, MO 65738-2293 | |
| (417) 459-2969 | |
| Not Available |
| Full Name | Mrs Beverly Dawn Harris |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 20 Years |
| Location | 2715 E Logan St, Republic, Missouri |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295896405 | NPI | - | NPPES |
| 491031100 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2006022591 (Missouri) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| College Skyline Center Llc | 0749383842 | 15 |
| Entity Name | Ozark Tri-county Health Care Consortium |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265428791 PECOS PAC ID: 8123918257 Enrollment ID: O20040330001501 |
| Entity Name | Ozark Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790796878 PECOS PAC ID: 4789588088 Enrollment ID: O20050223000110 |
| Entity Name | College Skyline Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598764110 PECOS PAC ID: 0749383842 Enrollment ID: O20070309000442 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Beverly Dawn Harris, MSW, PLCSW 2715 E Logan St, Republic, MO 65738-2293 Ph: (417) 459-2969 | Mrs Beverly Dawn Harris, MSW, PLCSW 2715 E Logan St, Republic, MO 65738-2293 Ph: (417) 459-2969 |
Cassady A Lilly, MSW, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 612 E Elm St, Republic, MO 65738 Phone: 417-761-5511 Fax: 417-761-5512 | |
Mary D Fletcher, MSW, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 612 E Elm St, Republic, MO 65738 Phone: 417-761-5000 Fax: 417-761-5065 | |
Cara Marie Shanks, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1074 S Gettysburg Loop, Republic, MO 65738 Phone: 417-268-8378 | |
Rachel D Mcelfresh, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 612 E Elm St, Republic, MO 65738 Phone: 417-761-5511 |