1447600218 NPI number — HARVEY COUNSELING SERVICES LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447600218 NPI number — HARVEY COUNSELING SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARVEY COUNSELING SERVICES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

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

NPI Number Information

NPI Number:
1447600218
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1181 MOSS GROVE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONCKS CORNER
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-687-8482
Provider Business Mailing Address Fax Number:
803-574-2039

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 CENTRAL AVENUE
Provider Second Line Business Practice Location Address:
SUITE 17 OF BUILDING 200
Provider Business Practice Location Address City Name:
GOOSE CREEK
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-687-8482
Provider Business Practice Location Address Fax Number:
803-574-2039
Provider Enumeration Date:
06/13/2016

Additional Information

Authorized Official

Authorized Official Last Name:
HARVEY
Authorized Official First Name:
ANGELA
Authorized Official Middle Name:
DENISE
Authorized Official Title or Position:
OWNER/THERAPIST
Authorized Official Telephone Number:
907-687-8482

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251S00000X , with the licence number: 6007 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: PC1718 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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