Provider Demographics
NPI:1467486696
Name:HARFORD, PHILIP M (LICSW)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:M
Last Name:HARFORD
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 MAPLEWOOD AVE STE C4
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-3787
Mailing Address - Country:US
Mailing Address - Phone:603-766-0137
Mailing Address - Fax:603-766-0138
Practice Address - Street 1:118 MAPLEWOOD AVE STE C4
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-3787
Practice Address - Country:US
Practice Address - Phone:603-766-0137
Practice Address - Fax:603-766-0138
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30423330Medicaid
NH14Y001226NH04OtherANTHEM BLUE CROSS
NH30423330Medicaid