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NPI Code Detail

MEDICARE: JAMI HARLAND MSW, LCSW

MEDICARE: JAMI HARLAND 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
11041C0700XClinical Social Worker149020345IL

General Provider Information

NPI Number : 1942796073
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMI HARLAND MSW, LCSW
Provider Business Mailing Address
First Line : 108 PHEASANT RUN
Second Line :
City : WOODLAWN
State : IL
Zip : 62898-1116
Country : US
Telephone Number : 618-316-3146
Fax Number :
Provider Business Practice Location Address
First Line : 3600 S WATER TOWER PL
Second Line :
City : MOUNT VERNON
State : IL
Zip : 62864-6589
Country : US
Telephone Number : 618-316-3146
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2018
Last Update Date : 07/01/2018

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