Provider Demographics
NPI:1114723681
Name:HARVEY, JENNILYN (LPC)
Entity type:Individual
Prefix:
First Name:JENNILYN
Middle Name:
Last Name:HARVEY
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 WHEATFIELD CT
Mailing Address - Street 2:
Mailing Address - City:TRAVELERS REST
Mailing Address - State:SC
Mailing Address - Zip Code:29690-7953
Mailing Address - Country:US
Mailing Address - Phone:856-381-3416
Mailing Address - Fax:
Practice Address - Street 1:300 WHEATFIELD CT
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-7953
Practice Address - Country:US
Practice Address - Phone:856-381-3416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9276101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional