Provider Demographics
NPI:1366166894
Name:HARVEY, STEPHEN TED (LPC-A)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:TED
Last Name:HARVEY
Suffix:
Gender:M
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 PRIVATE ROAD 1010
Mailing Address - Street 2:
Mailing Address - City:BIG SANDY
Mailing Address - State:TX
Mailing Address - Zip Code:75755-5756
Mailing Address - Country:US
Mailing Address - Phone:903-360-2129
Mailing Address - Fax:
Practice Address - Street 1:321 PRIVATE ROAD 1010
Practice Address - Street 2:
Practice Address - City:BIG SANDY
Practice Address - State:TX
Practice Address - Zip Code:75755-5756
Practice Address - Country:US
Practice Address - Phone:903-360-2129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86284101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional