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NPI Code Detail

MEDICARE: K C HARRISON LCSW

MEDICARE: K C HARRISON 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 Worker12660-CNV

General Provider Information

NPI Number : 1770094716
Entity Type Code : Individual
Provider Name (Legal Business Name) : K C HARRISON LCSW
Provider Business Mailing Address
First Line : 8760 W PATRICK LN UNIT 2085
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5312
Country : US
Telephone Number : 702-201-6007
Fax Number :
Provider Business Practice Location Address
First Line : 5576 S FORT APACHE RD STE 120
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-3607
Country : US
Telephone Number : 702-646-5437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2017
Last Update Date : 10/09/2025

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Directions to “ K C HARRISON LCSW” Practice Location

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