Provider Demographics
NPI:1417078924
Name:HARVEY, SAMUEL JOEL (ED D)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:JOEL
Last Name:HARVEY
Suffix:
Gender:M
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12890 HILLCREST RD
Mailing Address - Street 2:SUITE K-200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1504
Mailing Address - Country:US
Mailing Address - Phone:972-392-3926
Mailing Address - Fax:972-702-9428
Practice Address - Street 1:12890 HILLCREST RD
Practice Address - Street 2:SUITE K-200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1504
Practice Address - Country:US
Practice Address - Phone:972-392-3926
Practice Address - Fax:972-702-9428
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10717101Y00000X
TX2780106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist