Provider Demographics
NPI:1407235765
Name:HARVEY, SAUNDRA D (LPC)
Entity Type:Individual
Prefix:MS
First Name:SAUNDRA
Middle Name:D
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 1:431 SAINT JAMES AVE STE L-167
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-2768
Mailing Address - Country:US
Mailing Address - Phone:843-819-9775
Mailing Address - Fax:
Practice Address - Street 1:105 CENTRAL AVE STE 200B
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-3084
Practice Address - Country:US
Practice Address - Phone:843-819-9775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC435201Medicaid
SC3348Medicare PIN