Provider Demographics
NPI:1518573484
Name:HARVEY, CRYSTAL V (LMFT)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:V
Last Name:HARVEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 S TWILIGHT LN
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-6244
Mailing Address - Country:US
Mailing Address - Phone:804-654-9271
Mailing Address - Fax:
Practice Address - Street 1:12800 W CREEK PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-1116
Practice Address - Country:US
Practice Address - Phone:804-784-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717001770106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist