Provider Demographics
NPI:1316998842
Name:HARRIS, NANCY BISHOP (LICSW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:BISHOP
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:CAROLE
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:211 MAIN ST # B
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-3704
Mailing Address - Country:US
Mailing Address - Phone:401-398-2474
Mailing Address - Fax:
Practice Address - Street 1:33 COLLEGE HILL RD
Practice Address - Street 2:SUITE 30E
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2776
Practice Address - Country:US
Practice Address - Phone:401-821-6070
Practice Address - Fax:401-821-6047
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW015081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
62-40216OtherUNITED HEALTH CARE
411508OtherBLUECHIP
27306-4OtherBC/BS OF RI
2244847OtherCIGNA
62-40216OtherUNITED BEHAVIORAL HEALTH