Healthcare Provider Details

I. General information

NPI: 1215848973
Provider Name (Legal Business Name): DEMAELYUN HARVEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAE HARVEY

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8606 ALLISONVILLE RD STE 120
INDIANAPOLIS IN
46250-3585
US

IV. Provider business mailing address

8606 ALLISONVILLE RD STE 120
INDIANAPOLIS IN
46250-3585
US

V. Phone/Fax

Practice location:
  • Phone: 317-951-9358
  • Fax:
Mailing address:
  • Phone: 317-951-9358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: