MEDICARE: NANCY BISHOP HARRIS LICSW

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
1	1041C0700X	Clinical Social Worker	ISW01508	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	62-40216	OTHER	UNITED HEALTH CARE
2	411508	OTHER	BLUECHIP
3	27306-4	OTHER	BC/BS OF RI
4	2244847	OTHER	CIGNA
5	62-40216	OTHER	UNITED BEHAVIORAL HEALTH

General Provider Information

NPI Number	:	1316998842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY BISHOP HARRIS LICSW

Provider Business Mailing Address
First Line	:	211 MAIN ST # B
Second Line	:
City	:	EAST GREENWICH
State	:	RI
Zip	:	02818-3704
Country	:	US
Telephone Number	:	401-398-2474
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 COLLEGE HILL RD
Second Line	:	SUITE 30E
City	:	WARWICK
State	:	RI
Zip	:	02886-2776
Country	:	US
Telephone Number	:	401-821-6070
Fax Number	:	401-821-6047

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	07/08/2007

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Directions to “ NANCY BISHOP HARRIS LICSW” Practice Location

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