Provider Demographics
NPI:1558738559
Name:HARVEY, DUSTIN JAMES (MA, LPC-MHSP(T))
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:JAMES
Last Name:HARVEY
Suffix:
Gender:M
Credentials:MA, LPC-MHSP(T)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 WILLOW CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-3569
Mailing Address - Country:US
Mailing Address - Phone:865-306-4061
Mailing Address - Fax:
Practice Address - Street 1:408 N CEDAR BLUFF RD STE 305
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-3648
Practice Address - Country:US
Practice Address - Phone:865-888-5818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-25
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor