Carl Raye Harbison Jr, | |
3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | |
(573) 686-1200 | |
Not Available |
Full Name | Carl Raye Harbison Jr |
---|---|
Gender | Male |
Speciality | Counselor - Mental Health |
Location | 3001 Warrior Ln, Poplar Bluff, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174098115 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (Missouri) | Primary |
Entity Name | Big Springs Medical Association |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225045321 PECOS PAC ID: 6709871007 Enrollment ID: O20040416000695 |
Mailing Address | Practice Location Address |
---|---|
Carl Raye Harbison Jr, 923 W Russell St, Ironton, MO 63650-9123 Ph: (573) 915-6531 | Carl Raye Harbison Jr, 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 Ph: (573) 686-1200 |
Ms. Lydia Alpha Mabbitt, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3001 Warrior Ln, Poplar Bluff, MO 63901 Phone: 573-686-1200 Fax: 573-686-1029 | |
Ms. Christina J Cunningham, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 3001 Warrior Ln, Poplar Bluff, MO 63901 Phone: 573-686-1200 Fax: 573-686-1029 | |
Kristi Lynn Burns, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3001 Warrior Ln, Poplar Bluff, MO 63901 Phone: 573-686-1200 | |
Jeffrey E Killian, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1140 Herschel Bess Blvd, Poplar Bluff, MO 63901 Phone: 573-686-1200 Fax: 573-686-1029 | |
Mr. Larry Todd Allen, L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2725 N Westwood Blvd, Suite 5a, Poplar Bluff, MO 63901 Phone: 573-785-0333 Fax: 573-785-0333 | |
Sarah Montgomery, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3001 Warrior Ln, Poplar Bluff, MO 63901 Phone: 573-686-1328 Fax: 573-686-1029 | |
Miss Robin Denise Vickery, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3001 Warrior Ln, Poplar Bluff, MO 63901 Phone: 573-686-1200 Fax: 573-686-1029 |