Provider Demographics
NPI:1003305442
Name:HARVEY, BRENDAN MICHAEL (LPC)
Entity Type:Individual
Prefix:
First Name:BRENDAN
Middle Name:MICHAEL
Last Name:HARVEY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12335 HYMEADOW DR STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1935
Mailing Address - Country:US
Mailing Address - Phone:512-900-1833
Mailing Address - Fax:
Practice Address - Street 1:12343 HYMEADOW DR STE 2H
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750
Practice Address - Country:US
Practice Address - Phone:512-900-1833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73830101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health