Provider Demographics
NPI:1639825169
Name:HARVEY, CAROL FISH
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:FISH
Last Name:HARVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4970 OAK DR
Mailing Address - Street 2:
Mailing Address - City:LAFITTE
Mailing Address - State:LA
Mailing Address - Zip Code:70067-5246
Mailing Address - Country:US
Mailing Address - Phone:504-508-4531
Mailing Address - Fax:
Practice Address - Street 1:5417 EHRET RD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-5309
Practice Address - Country:US
Practice Address - Phone:504-341-0961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1701033Medicaid