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General NPI Number Information
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NPI Number | 1588869788
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Entity Type | Individual
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Provider Name | PETER STUYVESANT HARVEY LCPC, LMFT
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Gender | Male
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 03/30/2010
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Provider Practice Location Address
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Address Line | 834 FALLS AVE SUITE #1180
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City | TWIN FALLS
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State | ID
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Zip | 83301-3365
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Country | US
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Telephone | 208-734-2168
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Fax | 208-734-5354
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Provider Business Mailing Address
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Address Line | 834 FALLS AVE SUITE #1180
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City | TWIN FALLS
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State | ID
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Zip | 83301-3365
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Country | US
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Telephone | 208-734-2168
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Fax | 208-734-5354
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LCPC-38
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT-3038
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License Number State | ID
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