Provider Demographics
NPI:1952886541
Name:HARRISON, HENRY F (MASSACHUETTS LICSW)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:F
Last Name:HARRISON
Suffix:
Gender:M
Credentials:MASSACHUETTS LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-3402
Mailing Address - Country:US
Mailing Address - Phone:617-460-0225
Mailing Address - Fax:781-259-8818
Practice Address - Street 1:18 WINTER ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MA
Practice Address - Zip Code:01773-3402
Practice Address - Country:US
Practice Address - Phone:617-460-0225
Practice Address - Fax:781-259-8818
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1024147-SW-LICSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical