Provider Demographics
NPI:1336519420
Name:HARVEY, AUZADEH (LPC, LPCC, MS, NCC)
Entity type:Individual
Prefix:
First Name:AUZADEH
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:LPC, LPCC, MS, NCC
Other - Prefix:
Other - First Name:AUZADEH
Other - Middle Name:
Other - Last Name:BARTHOLF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, LPCC, MS, NCC
Mailing Address - Street 1:10175 NW 312TH PL
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINS
Mailing Address - State:OR
Mailing Address - Zip Code:97133-8246
Mailing Address - Country:US
Mailing Address - Phone:505-681-4790
Mailing Address - Fax:
Practice Address - Street 1:10175 NW 312TH PL
Practice Address - Street 2:
Practice Address - City:NORTH PLAINS
Practice Address - State:OR
Practice Address - Zip Code:97133-8246
Practice Address - Country:US
Practice Address - Phone:505-681-4790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012530101YM0800X
ORC3919101YM0800X
NM0177381101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health