Provider Demographics
NPI:1194073890
Name:HARVEY, LINDA S (LBSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:HARVEY
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N. WEST AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202
Mailing Address - Country:US
Mailing Address - Phone:517-780-3304
Mailing Address - Fax:517-787-1765
Practice Address - Street 1:1200 N WEST AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-2179
Practice Address - Country:US
Practice Address - Phone:517-780-3304
Practice Address - Fax:517-787-1765
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68020758071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical