Provider Demographics
NPI:1225902562
Name:HARVEY, LYNETTE J
Entity type:Individual
Prefix:MRS
First Name:LYNETTE
Middle Name:J
Last Name:HARVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 BUENA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:DEVENS
Mailing Address - State:MA
Mailing Address - Zip Code:01434-5025
Mailing Address - Country:US
Mailing Address - Phone:617-290-3896
Mailing Address - Fax:
Practice Address - Street 1:29 BUENA VISTA ST
Practice Address - Street 2:
Practice Address - City:DEVENS
Practice Address - State:MA
Practice Address - Zip Code:01434-5025
Practice Address - Country:US
Practice Address - Phone:617-290-3896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS85214176106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician