Provider Demographics
NPI:1326703935
Name:HARVEY, SHAWN COLE (LMFT)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:COLE
Last Name:HARVEY
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:NICOLE
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3020 CHILDRENS WAY # MC5165
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4223
Mailing Address - Country:US
Mailing Address - Phone:858-966-8493
Mailing Address - Fax:
Practice Address - Street 1:8110 BIRMINGHAM WAY BLDG 28
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2758
Practice Address - Country:US
Practice Address - Phone:858-966-8493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT145853106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist