Provider Demographics
NPI:1346202959
Name:HARMS, BRUCE WILLIAM (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:WILLIAM
Last Name:HARMS
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 1:4106 VISTA VERDE DR
Mailing Address - Street 2:APT 12
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1759
Mailing Address - Country:US
Mailing Address - Phone:727-264-6391
Mailing Address - Fax:727-494-7587
Practice Address - Street 1:4106 VISTA VERDE DR
Practice Address - Street 2:APT 12
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-1759
Practice Address - Country:US
Practice Address - Phone:727-264-6391
Practice Address - Fax:727-494-7587
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 83741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP9031Medicare PIN
FLK8633BMedicare PIN