Provider Demographics
NPI:1316357536
Name:HARVEY, MELTON (LPC)
Entity Type:Individual
Prefix:
First Name:MELTON
Middle Name:
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 1:2529 MOUNT ELLIOTT AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-2878
Mailing Address - Country:US
Mailing Address - Phone:810-265-3686
Mailing Address - Fax:
Practice Address - Street 1:2529 MOUNT ELLIOTT AVE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-2878
Practice Address - Country:US
Practice Address - Phone:810-265-3686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401003067101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional