Healthcare Provider Details

I. General information

NPI: 1114040417
Provider Name (Legal Business Name): KAREN JOY HARVEY MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 PRESIDENTIAL PL NE STE C
ALBUQUERQUE NM
87109-3442
US

IV. Provider business mailing address

7120 CABIN CT NW
ALBUQUERQUE NM
87120-2901
US

V. Phone/Fax

Practice location:
  • Phone: 505-345-3046
  • Fax: 505-343-1898
Mailing address:
  • Phone: 505-899-1299
  • Fax: 505-899-1299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0090981
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: