Provider Demographics
NPI:1275217416
Name:HARVEY, SELENA CHRISTINE (CADC)
Entity Type:Individual
Prefix:
First Name:SELENA
Middle Name:CHRISTINE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:SELENA
Other - Middle Name:C
Other - Last Name:BEASLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CADC
Mailing Address - Street 1:214 LONGLEAF PINES DR
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-5796
Mailing Address - Country:US
Mailing Address - Phone:910-583-4910
Mailing Address - Fax:
Practice Address - Street 1:2577 RAVENHILL DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5451
Practice Address - Country:US
Practice Address - Phone:910-438-0947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCADC-21846101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)