Provider Demographics
NPI:1659323996
Name:HARBER, CYNTHIA (LCSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:HARBER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-0030
Mailing Address - Country:US
Mailing Address - Phone:731-642-0521
Mailing Address - Fax:731-642-1010
Practice Address - Street 1:1263 US HIGHWAY 45 BYP N
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:TN
Practice Address - Zip Code:38382-4006
Practice Address - Country:US
Practice Address - Phone:731-855-2871
Practice Address - Fax:731-855-2877
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000038821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3987225Medicaid
TN3987225Medicare ID - Type Unspecified