Provider Demographics
NPI:1972838654
Name:HARVEY, LINDA ROSE (LSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ROSE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10813 GUFFEY RILLTON RD
Mailing Address - Street 2:
Mailing Address - City:RILLTON
Mailing Address - State:PA
Mailing Address - Zip Code:15678-2732
Mailing Address - Country:US
Mailing Address - Phone:724-446-7096
Mailing Address - Fax:
Practice Address - Street 1:10813 GUFFEY RILLTON RD
Practice Address - Street 2:
Practice Address - City:RILLTON
Practice Address - State:PA
Practice Address - Zip Code:15678-2732
Practice Address - Country:US
Practice Address - Phone:724-446-7096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW003227E101YP2500X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA653025Medicare PIN