Provider Demographics
NPI:1093413312
Name:HARVEY, BRADFORD HEATH
Entity Type:Individual
Prefix:
First Name:BRADFORD
Middle Name:HEATH
Last Name:HARVEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 VALLEYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43031-1150
Mailing Address - Country:US
Mailing Address - Phone:740-404-1337
Mailing Address - Fax:
Practice Address - Street 1:7440 BRIDLESPUR LN
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-8925
Practice Address - Country:US
Practice Address - Phone:614-560-5559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker