Provider Demographics
NPI:1932142593
Name:GAYER, HARVEY LOUIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:LOUIS
Last Name:GAYER
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 1:485 HUNTINGTON RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-1861
Mailing Address - Country:US
Mailing Address - Phone:706-546-8440
Mailing Address - Fax:706-546-8456
Practice Address - Street 1:485 HUNTINGTON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-1861
Practice Address - Country:US
Practice Address - Phone:706-546-8440
Practice Address - Fax:706-546-8456
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002137103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00762176AMedicaid