MEDICARE: ABIGAIL HARRIS LMSW-CC

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	MC26048	ME

General Provider Information

NPI Number	:	1992636104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL HARRIS LMSW-CC

Provider Business Mailing Address
First Line	:	400 RIVERSIDE ST UNIT A4
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-1068
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 RIVERSIDE ST UNIT A4
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-1068
Country	:	US
Telephone Number	:	207-747-8534
Fax Number	:

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

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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