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NPI Code Detail

MEDICARE: MRS. JULIE ANN HARRIS MSW, LCSW

MEDICARE: MRS. JULIE ANN HARRIS MSW, LCSW
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 Worker5115-CNV

General Provider Information

NPI Number : 1174694962
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JULIE ANN HARRIS MSW, LCSW
Provider Business Mailing Address
First Line : 3750 BARRELWOOD DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-6818
Country : US
Telephone Number : 702-220-5596
Fax Number :
Provider Business Practice Location Address
First Line : 4495 W HACIENDA AVE STE 7
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-1541
Country : US
Telephone Number : 702-385-5331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 07/08/2007

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