1598927303 NPI number — MICHELLE HARVEY, PHD CLINICAL HEALTH PSYCHOLOGY

Table of content: (NPI 1598927303)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598927303 NPI number — MICHELLE HARVEY, PHD CLINICAL HEALTH PSYCHOLOGY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHELLE HARVEY, PHD CLINICAL HEALTH PSYCHOLOGY
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:
1598927303
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5751 KROGER DR
Provider Second Line Business Mailing Address:
SUITE 244
Provider Business Mailing Address City Name:
KELLER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76244-5649
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-805-1510
Provider Business Mailing Address Fax Number:
817-581-9939

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5751 KROGER DR
Provider Second Line Business Practice Location Address:
SUITE 224
Provider Business Practice Location Address City Name:
FORT WORTH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76244-5632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-805-1510
Provider Business Practice Location Address Fax Number:
817-581-9939
Provider Enumeration Date:
07/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HARVEY
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
BETTE
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
817-805-1510

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , with the licence number:  32781 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 32781 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com