Provider Demographics
NPI:1427374065
Name:HARVEY, TRISTANA RENEE (PHD, NCC, LPC)
Entity Type:Individual
Prefix:DR
First Name:TRISTANA
Middle Name:RENEE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:PHD, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-0365
Mailing Address - Country:US
Mailing Address - Phone:814-321-1238
Mailing Address - Fax:866-305-1774
Practice Address - Street 1:25 E WASHINGTON ST
Practice Address - Street 2:SUITE 1602
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1708
Practice Address - Country:US
Practice Address - Phone:814-321-1238
Practice Address - Fax:866-305-1774
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC 003325101YP2500X
IL178.006702101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional