# B. SHANE HARMON LCSW, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326326273
- **Authorized official:** MR. B. SHANE HARMON LCSW (MANAGER)
- **Authorized official phone:** (801) 475-0402

## Contact information

- **Practice address:** 5149 S 1500 W, RIVERDALE, UT 84405-3926
- **Practice address phone:** (801) 475-0402
- **Practice address fax:** (801) 475-7464
- **Mailing address:** 5149 S 1500 W, RIVERDALE, UT 84405-3926
- **Mailing address phone:** (801) 475-0402
- **Mailing address fax:** (801) 475-7464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 141805-3501 | UT | Yes |

## Other

- **Enumeration date:** 07/26/2011
- **Last updated:** 07/26/2011