Provider Demographics
NPI:1609266592
Name:HARVEY, BIANCA K (MS, LPC-A)
Entity Type:Individual
Prefix:MISS
First Name:BIANCA
Middle Name:K
Last Name:HARVEY
Suffix:
Gender:F
Credentials:MS, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5824 BRITTANY CT APT BC83
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-5816
Mailing Address - Country:US
Mailing Address - Phone:347-365-0057
Mailing Address - Fax:
Practice Address - Street 1:3705 LATROBE DR STE 340
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-4823
Practice Address - Country:US
Practice Address - Phone:704-364-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11246101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional