Provider Demographics
NPI:1982883492
Name:HARVEY, M. SUSAN (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:M. SUSAN
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4628 PALMER CT
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-8339
Mailing Address - Country:US
Mailing Address - Phone:303-905-0994
Mailing Address - Fax:
Practice Address - Street 1:2975 VALMONT RD STE 310
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1361
Practice Address - Country:US
Practice Address - Phone:303-905-0994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4817OtherSTATE OF COLORADO, LICENSED PROFESSIONAL COUNSELOR