Healthcare Provider Details

I. General information

NPI: 1588006654
Provider Name (Legal Business Name): ANNA HARMLESS MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2013
Last Update Date: 09/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N ENGLEWOOD DR
CRAWFORDSVILLE IN
47933-9744
US

IV. Provider business mailing address

701 N ENGLEWOOD DR
CRAWFORDSVILLE IN
47933-9744
US

V. Phone/Fax

Practice location:
  • Phone: 765-361-9767
  • Fax: 765-361-0374
Mailing address:
  • Phone: 765-361-9767
  • Fax: 765-361-0374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34007330A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33006370
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: