Provider Demographics
NPI:1104037381
Name:HARDER, JAMES ROBERT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ROBERT
Last Name:HARDER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 W 78TH ST
Mailing Address - Street 2:APT 14D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6712
Mailing Address - Country:US
Mailing Address - Phone:212-974-1391
Mailing Address - Fax:212-974-1392
Practice Address - Street 1:173 W 78TH ST
Practice Address - Street 2:APT 14D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6712
Practice Address - Country:US
Practice Address - Phone:646-667-6162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-27
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR041889-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN59782Medicare ID - Type Unspecified