Crystal Marie Harris, LCSW
NPI 1083267165ActiveIndividual· Social Worker, Clinical· Fort Bragg, CA
Social Worker, Clinical (LCSW) with Sud Specialty Group - Ca and 1 other group, practicing in Fort Bragg, California. Enrolled in Medicare as practitioner - clinical social worker and practitioner - clinical social worker.
Overview
| NPI | 1083267165 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | No |
| NPI issued | Jul 18, 2019 |
| Last updated in NPPES | May 31, 2023 |
| Certified by provider | May 30, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 101995 | CA |
| Social Worker, Clinical | 1041C0700X | .09924293 | CO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (CA); Practitioner - Clinical Social Worker (CO) |
|---|
Education and affiliations
| Graduation year | 2006 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical groups
- Sud Specialty Group - CaSanta Clara, CA · 568 clinicians
- Mendocino Coast Clinics IncFort Bragg, CA · 22 clinicians
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All 20 clinical social workers in Fort Bragg · All clinical social workers in California