CARL RAYE HARBISON JR. (NPI# 1174098115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174098115 |
| Entity Type | Individual |
| Full Name | CARL RAYE HARBISON JR. |
| Practice Address |
3001 Warrior Ln Poplar Bluff MO 63901-8685 |
| Mailing Address |
923 W Russell St Ironton MO 63650-9123 |
| Practice Telephone | 5736861200 |
| Mailing Telephone | 5739156531 |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2018-10-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MO | Behavioral Health & Social Service Providers |
| Street Address |
3001 WARRIOR LN |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-8685 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083638506 | Robin Denise Vickery | Counselor | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2006-07-27 |
| 1235738493 | Family Counseling Center, Inc. | Clinic/Center | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-10-20 |
| 1972117620 | Selina Ann Mcklintic | Registered Nurse | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-09-01 |
| 1477163764 | Paula Kay Dawes | Case Manager/Care Coordinator | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-08-03 |
| 1275141921 | Matthew Owens | Behavior Technician | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-07-20 |
| 1730797564 | Holly Rebecca Carter | Counselor | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-07-17 |
| 1174144547 | Angela Michelle Slaughter | Case Manager/Care Coordinator | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-04-27 |
| 1215558655 | Ashley Don Scheffler | Case Manager/Care Coordinator | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-04-27 |
| 1922628510 | Jennifer Lee Taylor | Behavior Technician | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-04-23 |
| 1639708233 | Zackary James Ladyman | Licensed Practical Nurse | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104296078 | Melinda Gay Taylor Vii | Counselor | 615 Selma St, Poplar Bluff, MO 63901-4931 | 2015-10-04 |
| 1669684403 | Rodney Allan Messenger | Counselor | 1140 Herschel Bess Boulevard, Poplar Bluff, MO 63901 | 2007-05-04 |
| 1164065017 | Rebekah Clubb | Counselor | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2019-10-23 |
| 1194131466 | Racheal Ward | Counselor | 3001 Warrior Lane, Family Counseling Center, Inc., Poplar Bluff, MO 63901 | 2014-07-08 |
| 1033522412 | Charissa Young | Counselor | 3001 Warrior Ln, Poplar Bluff, MO 63901 | 2014-06-03 |
| 1083026421 | Sarah Montgomery | Counselor | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2014-05-20 |
| 1811328958 | Kristie Keasler | Counselor | 621 W Pine St, Poplar Bluff, MO 63901-5042 | 2013-11-27 |
| 1801166160 | Verlin George Luna Jr. | Counselor | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2012-01-04 |
| 1114224334 | Lisa L Brooks | Counselor | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2011-02-24 |
| 1831367572 | Cerendia Woollums | Counselor | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2008-02-15 |
| Find all providers in POPLAR BLUFF | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.