Provider Demographics
NPI:1235302225
Name:HARVEY, SANDRA HELEN (LPC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:HELEN
Last Name:HARVEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 HILL DR STE E
Mailing Address - Street 2:
Mailing Address - City:GRENADA
Mailing Address - State:MS
Mailing Address - Zip Code:38901-5071
Mailing Address - Country:US
Mailing Address - Phone:662-226-9098
Mailing Address - Fax:662-226-9098
Practice Address - Street 1:1800 HILL DR STE E
Practice Address - Street 2:
Practice Address - City:GRENADA
Practice Address - State:MS
Practice Address - Zip Code:38901-5071
Practice Address - Country:US
Practice Address - Phone:662-226-9098
Practice Address - Fax:662-226-9098
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1258101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health