Provider Demographics
NPI:1487277984
Name:HARVEY, BONNIE (LMHCA)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 S STADIUM WAY
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-4802
Mailing Address - Country:US
Mailing Address - Phone:206-778-9839
Mailing Address - Fax:
Practice Address - Street 1:24216 138TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-5186
Practice Address - Country:US
Practice Address - Phone:206-778-9839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60994669101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health