Provider Demographics
NPI:1407810757
Name:HARBERT, TERRY LEE (MSW)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:LEE
Last Name:HARBERT
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 SW GAGE BLVD
Mailing Address - Street 2:SOCIAL WORK SERVICE
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66622-0001
Mailing Address - Country:US
Mailing Address - Phone:785-350-4641
Mailing Address - Fax:785-350-4527
Practice Address - Street 1:2200 SW GAGE BLVD
Practice Address - Street 2:SOCIAL WORK SERVICE
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66622-0001
Practice Address - Country:US
Practice Address - Phone:785-350-4641
Practice Address - Fax:785-350-4527
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical