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General NPI Number Information
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NPI Number | 1992581284
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Entity Type | Individual
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Provider Name | SAMUEL HARKNESS MSW, SWLC
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Gender | Male
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Dates
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Enumeration Date | 09/04/2023
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Last Update Date | 09/04/2023
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Provider Practice Location Address
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Address Line | 144 2ND ST E STE 202
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City | WHITEFISH
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State | MT
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Zip | 59937-2402
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Country | US
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Telephone | 406-260-3279
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Fax |
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Provider Business Mailing Address
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Address Line | 1675 2ND ST E
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City | WHITEFISH
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State | MT
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Zip | 59937-8149
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Country | US
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Telephone | 406-260-3279
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Fax | 406-260-3279
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | BBH-SWLM-LIC-64449
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License Number State | MT
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