Provider Demographics
NPI:1659625804
Name:HARVEY, WALLACE E (LPC, LCAC)
Entity type:Individual
Prefix:
First Name:WALLACE
Middle Name:E
Last Name:HARVEY
Suffix:
Gender:M
Credentials:LPC, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-8537
Mailing Address - Country:US
Mailing Address - Phone:785-825-6224
Mailing Address - Fax:316-686-0036
Practice Address - Street 1:617 E ELM ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-8537
Practice Address - Country:US
Practice Address - Phone:785-825-6224
Practice Address - Fax:785-833-5368
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS391101YA0400X
KS03872101YP2500X
KS665101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional