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Stephayne Johanne Harris

Social Worker

Behavioral Health & Social Service Providers

3796 Broadway, Grove City, OH 43123-2235

PECOS Enrollment

This provider is enrolled in PECOS as STEPHAYNE HARRIS.

Based on the most recent information from CMS, provider Stephayne Johanne Harris is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1720062565
Provider Type
Individual
Full Name
Harris, Stephayne Johanne
Credential
LISW

Gender
Female
Enumeration Date
12/5/2005
Last Updated
7/8/2007

Contact Information

Practice Location

3796 Broadway, Grove City, OH 43123-2235

(614) 871-0035

(614) 539-0069

Mailing Location

3796 Broadway, Grove City, OH 43123-2235

(614) 871-0035

(614) 539-0069

Provider Taxonomies

Code	Description	License
Code 104100000X Primary	Description Social Worker Behavioral Health & Social Service Providers	License I5333 Ohio

Stephayne Johanne Harris

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Delcher, Christopher Quintin

Ali, Rabia

Smith-Carter, Cierra

Sheets, Kassandra

Syrus, Heather Lynn

Gardner, Katelynn

Lamb, Sandra Marie

Pickering, Paige Nicole

Hoyos, Kirsten

Bare, Brandi Nicole