Provider Demographics
NPI:1326534785
Name:HARNETT, ABIGAIL (LCSW, CMHP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:HARNETT
Suffix:
Gender:F
Credentials:LCSW, CMHP
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 562
Mailing Address - Street 2:
Mailing Address - City:THOMPSON FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59873-0562
Mailing Address - Country:US
Mailing Address - Phone:406-532-9190
Mailing Address - Fax:406-206-5133
Practice Address - Street 1:602 PRESTON AVE W
Practice Address - Street 2:
Practice Address - City:THOMPSON FALLS
Practice Address - State:MT
Practice Address - Zip Code:59873-9319
Practice Address - Country:US
Practice Address - Phone:406-532-9190
Practice Address - Fax:406-206-5133
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-178551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical