Provider Demographics
NPI:1588869788
Name:HARVEY, PETER STUYVESANT (LCPC, LMFT)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:STUYVESANT
Last Name:HARVEY
Suffix:
Gender:M
Credentials:LCPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 FALLS AVE
Mailing Address - Street 2:SUITE #1180
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3365
Mailing Address - Country:US
Mailing Address - Phone:208-734-2168
Mailing Address - Fax:208-734-5354
Practice Address - Street 1:834 FALLS AVE
Practice Address - Street 2:SUITE #1180
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3365
Practice Address - Country:US
Practice Address - Phone:208-734-2168
Practice Address - Fax:208-734-5354
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-38101YP2500X
IDLMFT-3038106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist