Ralph Harriman IV, LMSW
Individual provider Active NPI Social Worker · Shelley, ID
NPI 1194120980 · NPPES record last updated Oct 23, 2014
Key facts
- NPI
- 1194120980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 1006 N Highway 91
Shelley, ID 83274-5202 - Phone
- (208) 360-6170
- NPI assigned
- Oct 23, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
1006 N Highway 91
Shelley, ID 83274-5202
Mailing address
1006 N Highway 91
Shelley, ID 83274-5202
Other providers in Shelley, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.