Provider Demographics
NPI:1922860527
Name:HARVEY, LILLIAN XENIA (LCMHC)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:XENIA
Last Name:HARVEY
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:LYLLIE
Other - Middle Name:XENIA
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCMHC
Mailing Address - Street 1:1 MILL ST STE 312
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1523
Mailing Address - Country:US
Mailing Address - Phone:802-870-6243
Mailing Address - Fax:
Practice Address - Street 1:1 MILL ST STE 312
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1523
Practice Address - Country:US
Practice Address - Phone:802-870-6243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0135699101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health