MEDICARE: ANNE S HARRIS 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	104100000X	Social Worker	194LCSW	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	71280	OTHER	MT	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1649266537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE S HARRIS LCSW

Provider Business Mailing Address
First Line	:	490 N 31ST ST STE 107
Second Line	:	TRANSWESTERN 2
City	:	BILLINGS
State	:	MT
Zip	:	59101-1256
Country	:	US
Telephone Number	:	406-860-3754
Fax Number	:

Provider Business Practice Location Address
First Line	:	490 N 31ST ST STE 107
Second Line	:	TRANSWESTERN 2
City	:	BILLINGS
State	:	MT
Zip	:	59101-1256
Country	:	US
Telephone Number	:	406-860-3754
Fax Number	:

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

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	09/22/2010

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