Provider Demographics
NPI:1942958723
Name:ANGELA HARRIS, LCSW PLLC
Entity Type:Organization
Organization Name:ANGELA HARRIS, LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-540-5480
Mailing Address - Street 1:PO BOX 2233
Mailing Address - Street 2:
Mailing Address - City:BIGFORK
Mailing Address - State:MT
Mailing Address - Zip Code:59911-2233
Mailing Address - Country:US
Mailing Address - Phone:406-540-5480
Mailing Address - Fax:406-540-5479
Practice Address - Street 1:7935 MT HIGHWAY 35 STE 202
Practice Address - Street 2:
Practice Address - City:BIGFORK
Practice Address - State:MT
Practice Address - Zip Code:59911-5711
Practice Address - Country:US
Practice Address - Phone:406-540-5480
Practice Address - Fax:406-540-5479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty