MEDICARE: JOHN PATRICK HARPER 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
1	1041C0700X	Clinical Social Worker	4174-C	NV

General Provider Information

NPI Number	:	1609883552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN PATRICK HARPER LCSW

Provider Business Mailing Address
First Line	:	6171 W CHARLESTON BLVD
Second Line	:	BUILDING 8
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1126
Country	:	US
Telephone Number	:	702-486-6871
Fax Number	:	702-486-6871

Provider Business Practice Location Address
First Line	:	6171 W CHARLESTON BLVD
Second Line	:	BUILDING 8
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1126
Country	:	US
Telephone Number	:	702-486-6871
Fax Number	:	702-486-6871

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	06/25/2012

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