Healthcare Provider Details

I. General information

NPI: 1932566080
Provider Name (Legal Business Name): KRISTINE HARVEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2016
Last Update Date: 01/04/2026
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 ULMERTON RD STE 210
CLEARWATER FL
33762-3369
US

IV. Provider business mailing address

12131 OLIVE JONES RD
TAMPA FL
33625-3936
US

V. Phone/Fax

Practice location:
  • Phone: 833-488-3255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH24882
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: