Provider Demographics
NPI:1265995500
Name:GARVEY, JAMIE (PSYD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:GARVEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:LACEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:333 N MICHIGAN AVE STE 1900
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-3994
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:SAINT LIAM HALL
Practice Address - Street 2:220 MAIN BUILDIG
Practice Address - City:NOTRE DAME
Practice Address - State:IN
Practice Address - Zip Code:46556
Practice Address - Country:US
Practice Address - Phone:574-631-7336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20043290A103TC0700X
IL071.010002103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical