Provider Demographics
NPI:1013759869
Name:HARVEY, CHARLA
Entity type:Individual
Prefix:
First Name:CHARLA
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 IRIS AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1998
Mailing Address - Country:US
Mailing Address - Phone:303-775-0032
Mailing Address - Fax:
Practice Address - Street 1:3333 IRIS AVE STE 209
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1998
Practice Address - Country:US
Practice Address - Phone:303-775-0032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health