Healthcare Provider Details

I. General information

NPI: 1942958723
Provider Name (Legal Business Name): ANGELA HARRIS, LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2022
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7935 MT HIGHWAY 35 STE 202
BIGFORK MT
59911-5711
US

IV. Provider business mailing address

PO BOX 2233
BIGFORK MT
59911-2233
US

V. Phone/Fax

Practice location:
  • Phone: 406-540-5480
  • Fax: 406-540-5479
Mailing address:
  • Phone: 406-540-5480
  • Fax: 406-540-5479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ANGELA HARRIS
Title or Position: OWNER
Credential: LCSW
Phone: 406-540-5480