Provider Demographics
NPI:1821144015
Name:HARVEY, ERIC R (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:R
Last Name:HARVEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S JAMES ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-2166
Mailing Address - Country:US
Mailing Address - Phone:231-845-2900
Mailing Address - Fax:231-845-2905
Practice Address - Street 1:101 S JAMES ST
Practice Address - Street 2:SUITE 215
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-2166
Practice Address - Country:US
Practice Address - Phone:231-845-2900
Practice Address - Fax:231-845-2905
Is Sole Proprietor?:No
Enumeration Date:2007-01-28
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301001424103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N94970Medicare ID - Type Unspecified