Provider Demographics
NPI:1902205164
Name:HARVEY, LORI
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:GRIMES-HARVEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LBS
Mailing Address - Street 1:1501 LIGONIER ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-2912
Mailing Address - Country:US
Mailing Address - Phone:724-804-7297
Mailing Address - Fax:724-805-0166
Practice Address - Street 1:1501 LIGONIER ST STE 200
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-2912
Practice Address - Country:US
Practice Address - Phone:724-804-7297
Practice Address - Fax:724-805-0166
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002278103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst