MEDICARE: DR. SEBASTIAN HARVEY PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	6628	CO

General Provider Information

NPI Number	:	1891261889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEBASTIAN HARVEY PSYD

Provider Business Mailing Address
First Line	:	1000 CEDAR ST
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80020-1449
Country	:	US
Telephone Number	:	720-218-5661
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 S JACKSON ST STE 210
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80209-3134
Country	:	US
Telephone Number	:	303-704-4062
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2018
Last Update Date	:	12/10/2024

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