Healthcare Provider Details

I. General information

NPI: 1770548026
Provider Name (Legal Business Name): PAULA R HARBERT LSCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VAMC 2200 GAGE
TOPEKA KS
66622-0001
US

IV. Provider business mailing address

VAMC 2200 GAGE
TOPEKA KS
66622-0001
US

V. Phone/Fax

Practice location:
  • Phone: 785-350-3111
  • Fax: 785-350-4471
Mailing address:
  • Phone: 785-350-3111
  • Fax: 785-350-4471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSCSW
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: