Individual provider Active NPI

Carl Raye Harbison Jr.

  • Mental Health Counselor
  • Poplar Bluff, MO
National Provider Identifier
1174098115
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2018037840 Issued in MO
Practice address
2210 Barron Rd Ste 120
Poplar Bluff, MO 63901-1922
Phone
(573) 785-6536
Fax
(573) 785-0100
NPI assigned
Oct 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2018037840 MO Primary

Addresses

Primary practice location

2210 Barron Rd Ste 120
Poplar Bluff, MO 63901-1922

Mailing address

110 S 2ND St
Ellington, MO 63638-9400
Phone (573) 663-2313

Other practice location 1

17959 Main St
Eminence, MO 65466-6375
Phone (573) 226-5505

Other practice location 2

225 Physicians Park Ste 304
Poplar Bluff, MO 63901-3930
Phone (573) 727-5500 ext. 7

Other practice location 3

109 Plum St Ste B
Doniphan, MO 63935-1225
Phone (573) 351-0220

Other practice location 4

61 Highway Y
Ellington, MO 63638-7802
Phone (573) 663-2525

Other practice location 5

315 W Mulberry Ste A
Pilot Knob, MO 63663-7883
Phone (573) 546-0602

Other practice location 6

109 Plum St Ste A
Doniphan, MO 63935-1225
Phone (573) 351-0150

Other practice location 7

1 Hals Plz Ste A
Piedmont, MO 63957-1631
Phone (573) 223-4800

Other practice location 8

109 LeRoux St
Doniphan, MO 63935-1038
Phone (573) 996-2136

Other practice location 9

3277 US Highway 160 W
Doniphan, MO 63935-5710
Phone (573) 804-9527

Other practice location 10

289 Broadway St
Neelyville, MO 63954-7176
Phone (573) 804-9494

Other practice location 11

2300 Baugh Ln
Poplar Bluff, MO 63901-2402
Phone (573) 785-3037 ext. 16044

Other practice location 12

1300 Victory Ln
Poplar Bluff, MO 63901-3300
Phone (573) 785-5566 ext. 17097

Other practice location 13

11001 US-160
Harviell, MO 63945
Phone (573) 804-9561

Other practice location 14

225 Physicians Park Ste 200
Poplar Bluff, MO 63901-3921
Phone (573) 727-5500 ext. 5

Other practice location 15

220 East Broad Street
Naylor, MO 63953
Phone (573) 399-2311

Other practice location 16

711 Nickey St
Poplar Bluff, MO 63901-6544
Phone (573) 785-7047 ext. 13040

Other practice location 17

405 Main Street
Van Buren, MO 63965
Phone (573) 323-4253

Other practice location 18

101 E Batten Street
Naylor, MO 63901
Phone (573) 804-1779

Other practice location 19

603 E Summit St
Doniphan, MO 63935-1142
Phone (573) 996-3667 ext. 1117

Other practice location 20

2879 James Blvd
Poplar Bluff, MO 63901-3395
Phone (573) 609-8800

Other practice location 21

2879 James Blvd
Poplar Bluff, MO 63901-3395
Phone (573) 712-1610

Other practice location 22

225 Physicians Park Ste 102
Poplar Bluff, MO 63901-3918
Phone (573) 727-5500 ext. 2

Other practice location 23

202 Allen St
Annapolis, MO 63620-8778
Phone (573) 598-4213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240206004221 MO Practitioner - Mental Health Counselor 7315380383 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Big Springs Medical AssociationGroup PAC ID 6709871007, 53 clinicians

Practice addresses (Care Compare)

225 Physicians Park
Suite 304
Poplar Bluff, MO 63901-3930
Phone (573) 663-2313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018037840MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Big Springs Medical Association CurrentSince Jan 1, 2024 Accepting new patients
Big Springs Medical Association Current Accepting new patients
Big Springs Medical Association CurrentSince Jan 1, 2024 Accepting new patients
Mental Health Specialty Group PA Mental Health CurrentSince Aug 1, 2025 Accepting new patients

Locations

202 Allen St
Annapolis, MO 63620
Phone (573) 598-4213

109 Plum St
Doniphan, MO 63935
Phone (573) 776-2136

109 Plum St
Ste B
Doniphan, MO 63935
Phone (573) 351-0220

109 Leroux St
Doniphan, MO 63935
Phone (573) 996-2136

3277 US Highway 160 W
Doniphan, MO 63935

110 S 2nd St
Ellington, MO 63638
Phone (573) 663-2316

61 Highway Y
Ellington, MO 63638
Phone (573) 663-2525

1 Hals Plz
Piedmont, MO 63957
Phone (573) 223-4800

2210 Barron Rd
Ste 120
Poplar Bluff, MO 63901
Phone (573) 785-2005

3001 Warrior Ln
Poplar Bluff, MO 63901
Phone (573) 785-7453

2879 James Blvd
Poplar Bluff, MO 63901
Phone (573) 609-8800

18 Viburnum Center Rd
Viburnum, MO 65566
Phone (573) 244-5406

Interoperability endpoints

  • Direct secure messaging: carl.harbison.1@14422.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1174098115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S 2ND ST",
            "city": "ELLINGTON",
            "state": "MO",
            "postal_code": "636389400",
            "telephone_number": "573-663-2313",
            "fax_number": "573-663-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD STE 120",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011922",
            "telephone_number": "573-785-6536",
            "fax_number": "573-785-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17959 Main St",
            "address_purpose": "LOCATION",
            "city": "Eminence",
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            "postal_code": "654666375",
            "country_code": "US",
            "telephone_number": "573-226-5505",
            "fax_number": "573-226-1256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 Physicians Park Ste 304",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639013930",
            "country_code": "US",
            "telephone_number": "573-727-5500 x7",
            "fax_number": "573-399-2646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 Plum St Ste B",
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            "postal_code": "639351225",
            "country_code": "US",
            "telephone_number": "573-351-0220",
            "fax_number": "573-996-2246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "61 Highway Y",
            "address_purpose": "LOCATION",
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            "state": "MO",
            "postal_code": "636387802",
            "country_code": "US",
            "telephone_number": "573-663-2525",
            "fax_number": "573-663-7844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 W Mulberry Ste A",
            "address_purpose": "LOCATION",
            "city": "Pilot Knob",
            "state": "MO",
            "postal_code": "636637883",
            "country_code": "US",
            "telephone_number": "573-546-0602",
            "fax_number": "573-546-0546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 Plum St Ste A",
            "address_purpose": "LOCATION",
            "city": "Doniphan",
            "state": "MO",
            "postal_code": "639351225",
            "country_code": "US",
            "telephone_number": "573-351-0150",
            "fax_number": "573-996-2245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Hals Plz Ste A",
            "address_purpose": "LOCATION",
            "city": "Piedmont",
            "state": "MO",
            "postal_code": "639571631",
            "country_code": "US",
            "telephone_number": "573-223-4800",
            "fax_number": "573-223-7911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 LeRoux St",
            "address_purpose": "LOCATION",
            "city": "Doniphan",
            "state": "MO",
            "postal_code": "639351038",
            "country_code": "US",
            "telephone_number": "573-996-2136",
            "fax_number": "573-996-5216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3277 US Highway 160 W",
            "address_purpose": "LOCATION",
            "city": "Doniphan",
            "state": "MO",
            "postal_code": "639355710",
            "country_code": "US",
            "telephone_number": "573-804-9527",
            "fax_number": "573-804-9536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "289 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Neelyville",
            "state": "MO",
            "postal_code": "639547176",
            "country_code": "US",
            "telephone_number": "573-804-9494",
            "fax_number": "573-804-9493",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2300 Baugh Ln",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639012402",
            "country_code": "US",
            "telephone_number": "573-785-3037 x16044",
            "fax_number": "573-413-4506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Victory Ln",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639013300",
            "country_code": "US",
            "telephone_number": "573-785-5566 x17097",
            "fax_number": "573-413-4194",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11001 US-160",
            "address_purpose": "LOCATION",
            "city": "Harviell",
            "state": "MO",
            "postal_code": "63945",
            "country_code": "US",
            "telephone_number": "573-804-9561",
            "fax_number": "573-804-9581",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 Physicians Park Ste 200",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639013921",
            "country_code": "US",
            "telephone_number": "573-727-5500 x5",
            "fax_number": "573-313-3684",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 East Broad Street",
            "address_purpose": "LOCATION",
            "city": "Naylor",
            "state": "MO",
            "postal_code": "63953",
            "country_code": "US",
            "telephone_number": "573-399-2311",
            "fax_number": "573-399-2076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "711 Nickey St",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639016544",
            "country_code": "US",
            "telephone_number": "573-785-7047 x13040",
            "fax_number": "573-413-4192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Main Street",
            "address_purpose": "LOCATION",
            "city": "Van Buren",
            "state": "MO",
            "postal_code": "63965",
            "country_code": "US",
            "telephone_number": "573-323-4253",
            "fax_number": "573-323-0154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E Batten Street",
            "address_purpose": "LOCATION",
            "city": "Naylor",
            "state": "MO",
            "postal_code": "63901",
            "country_code": "US",
            "telephone_number": "573-804-1779",
            "fax_number": "573-804-1789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "603 E Summit St",
            "address_purpose": "LOCATION",
            "city": "Doniphan",
            "state": "MO",
            "postal_code": "639351142",
            "country_code": "US",
            "telephone_number": "573-996-3667 x1117",
            "fax_number": "573-413-4487",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2879 James Blvd",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639013395",
            "country_code": "US",
            "telephone_number": "573-609-8800",
            "fax_number": "573-776-6124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2879 James Blvd",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639013395",
            "country_code": "US",
            "telephone_number": "573-712-1610",
            "fax_number": "573-776-6124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 Physicians Park Ste 102",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639013918",
            "country_code": "US",
            "telephone_number": "573-727-5500 x2",
            "fax_number": "573-413-4609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "202 Allen St",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MO",
            "postal_code": "636208778",
            "country_code": "US",
            "telephone_number": "573-598-4213",
            "fax_number": "573-598-1101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARBISON",
        "first_name": "CARL",
        "middle_name": "RAYE",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-05",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2018037840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.