Provider Demographics
NPI:1487785697
Name:KIRBY, HAROLD DUREL (LCSW)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:DUREL
Last Name:KIRBY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9938 AIRLINE HWY
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-8100
Mailing Address - Country:US
Mailing Address - Phone:225-663-2881
Mailing Address - Fax:225-590-3843
Practice Address - Street 1:9938 AIRLINE HWY STE 290
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8100
Practice Address - Country:US
Practice Address - Phone:256-633-2881
Practice Address - Fax:225-590-3843
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR29951041C0700X
171M00000X
LA71511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP33321Medicare UPIN
OR109652Medicare ID - Type Unspecified