Provider Demographics
NPI:1235759598
Name:HARVEY, JOEL
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:
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:PO BOX 13474
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36663-0474
Mailing Address - Country:US
Mailing Address - Phone:251-751-4169
Mailing Address - Fax:251-345-4049
Practice Address - Street 1:2300 BENNETT DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36618-1538
Practice Address - Country:US
Practice Address - Phone:251-751-4169
Practice Address - Fax:251-345-4049
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2017086103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst