Provider Demographics
NPI:1669557294
Name:HARVEY, REBECCA (LMSW-ACP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:LMSW-ACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 CALLAGHAN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1128
Mailing Address - Country:US
Mailing Address - Phone:210-244-4898
Mailing Address - Fax:
Practice Address - Street 1:5805 CALLAGHAN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1128
Practice Address - Country:US
Practice Address - Phone:210-244-4898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS118411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0064CYOtherBCBS
TX063873601Medicaid
TX063873601Medicaid