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NPI Code Detail

MEDICARE: JESSICA ANN HARRISON LCSW-C

MEDICARE: JESSICA ANN HARRISON LCSW-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker21961MD

General Provider Information

NPI Number : 1124622014
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA ANN HARRISON LCSW-C
Provider Business Mailing Address
First Line : 5062 JUDICIAL WAY
Second Line :
City : FREDERICK
State : MD
Zip : 21703-4807
Country : US
Telephone Number : 908-227-8864
Fax Number : 667-600-4038
Provider Business Practice Location Address
First Line : 2700 WASHINGTON AVE
Second Line :
City : HALETHORPE
State : MD
Zip : 21227-3115
Country : US
Telephone Number : 667-600-3984
Fax Number : 667-600-4065
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2020
Last Update Date : 07/13/2023

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