Individual
SHANE M HARKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1300 E A ST STE 201, CASPER, WY 82601-2252
(207) 235-3333
Mailing address
3580 VALLEY RD, CASPER, WY 82604-4906
(307) 267-1792
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-839
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135466300
—
WY
Enumeration date
05/13/2013
Last updated
01/07/2020
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