Provider Demographics
NPI:1134461734
Name:HARRINGTON, ROY EDWARD (LMSW)
Entity Type:Individual
Prefix:MR
First Name:ROY
Middle Name:EDWARD
Last Name:HARRINGTON
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 MUNICIPAL DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-3984
Mailing Address - Country:US
Mailing Address - Phone:505-860-5038
Mailing Address - Fax:
Practice Address - Street 1:218 E CHUSKA ST
Practice Address - Street 2:
Practice Address - City:AZTEC
Practice Address - State:NM
Practice Address - Zip Code:87410-2113
Practice Address - Country:US
Practice Address - Phone:505-333-7042
Practice Address - Fax:505-333-7043
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-08016104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker