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NPI Code Detail

MEDICARE: DUSTIN JAMES HARVEY MA, LPC-MHSP(T)

MEDICARE: DUSTIN JAMES HARVEY MA, LPC-MHSP(T)
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1558738559
Entity Type Code : Individual
Provider Name (Legal Business Name) : DUSTIN JAMES HARVEY MA, LPC-MHSP(T)
Provider Business Mailing Address
First Line : 1048 WILLOW CREEK CIR
Second Line :
City : MARYVILLE
State : TN
Zip : 37804-3569
Country : US
Telephone Number : 865-306-4061
Fax Number :
Provider Business Practice Location Address
First Line : 408 N CEDAR BLUFF RD STE 305
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-3648
Country : US
Telephone Number : 865-888-5818
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2015
Last Update Date : 06/29/2022

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