Provider Demographics
NPI:1104058262
Name:HARVEY, DAVE A (LCSW)
Entity type:Individual
Prefix:
First Name:DAVE
Middle Name:A
Last Name:HARVEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 WARD HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:WEDOWEE
Mailing Address - State:AL
Mailing Address - Zip Code:36278-8404
Mailing Address - Country:US
Mailing Address - Phone:256-363-3922
Mailing Address - Fax:
Practice Address - Street 1:129 WARD HAVEN DR
Practice Address - Street 2:
Practice Address - City:WEDOWEE
Practice Address - State:AL
Practice Address - Zip Code:36278-8404
Practice Address - Country:US
Practice Address - Phone:256-393-3922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0373C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical