Provider Demographics
NPI:1699836957
Name:HARBIN, FRANK ROCKWELL (PHD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:ROCKWELL
Last Name:HARBIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 TECHNOLOGY PKWY NW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1369
Mailing Address - Country:US
Mailing Address - Phone:762-235-1000
Mailing Address - Fax:
Practice Address - Street 1:701 BROAD ST STE 350
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-3092
Practice Address - Country:US
Practice Address - Phone:706-295-2028
Practice Address - Fax:706-295-2062
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY001543103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000453868AMedicaid
S20392Medicare UPIN
GA68BBBGFMedicare ID - Type Unspecified