Provider Demographics
NPI:1962759530
Name:HARRIS, JESSE JO (LCSW)
Entity type:Individual
Prefix:MS
First Name:JESSE
Middle Name:JO
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30743
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59107-0743
Mailing Address - Country:US
Mailing Address - Phone:406-855-2517
Mailing Address - Fax:
Practice Address - Street 1:301 N 27TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1261
Practice Address - Country:US
Practice Address - Phone:406-696-3522
Practice Address - Fax:406-256-5232
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-13
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSWP-LCSW-LIC-112771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical