Provider Demographics
NPI:1922442268
Name:BATTRAW, HARRY TILFORD (LMSW)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:TILFORD
Last Name:BATTRAW
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 1:1547 E HILTON AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-5940
Mailing Address - Country:US
Mailing Address - Phone:480-588-8221
Mailing Address - Fax:
Practice Address - Street 1:1455 S STAPLEY DR STE 13
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-5851
Practice Address - Country:US
Practice Address - Phone:602-685-6000
Practice Address - Fax:480-834-5703
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-12326104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker