MEDICARE: MR. BARRY HARNICK 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
1	1041C0700X	Clinical Social Worker	SW4122	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710104781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BARRY HARNICK MSW, LCSW

Provider Business Mailing Address
First Line	:	6226 SAND HILLS CIR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-8226
Country	:	US
Telephone Number	:	561-945-4785
Fax Number	:	561-357-4779

Provider Business Practice Location Address
First Line	:	6226 SAND HILLS CIR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-8226
Country	:	US
Telephone Number	:	561-945-4785
Fax Number	:	561-357-4779

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

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	07/08/2007

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