1144547860 NPI number — ALICIA K. HARVEY EDS., LPC-S, RAT-S

Table of content: ALICIA K. HARVEY EDS., LPC-S, RAT-S (NPI 1144547860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144547860 NPI number — ALICIA K. HARVEY EDS., LPC-S, RAT-S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARVEY
Provider First Name:
ALICIA
Provider Middle Name:
K.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
EDS., LPC-S, RAT-S
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARVEY
Provider Other First Name:
LYSSA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1144547860
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5115 FOREST PLAZA
Provider Second Line Business Mailing Address:
SUITE D
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-920-0707
Provider Business Mailing Address Fax Number:
803-779-3364

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5115 FOREST PLAZA SUITE D
Provider Second Line Business Practice Location Address:
THE ART AND PLAY THERAPY CENTER OF S.C.
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-920-0707
Provider Business Practice Location Address Fax Number:
803-779-3364
Provider Enumeration Date:
04/21/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  #LPC2326 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 221700000X , with the licence number: #94-671 ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)