Basic Information
Provider Information
NPI: 1811102684
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARVEY
FirstName: DEBARAH
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: LMHP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 124 S 24TH ST
Address2: STE 230
City: OMAHA
State: NE
PostalCode: 681021226
CountryCode: US
TelephoneNumber: 4029785656
FaxNumber: 4025915075
Practice Location
Address1: 120 E 12TH ST
Address2:  
City: NORTH PLATTE
State: NE
PostalCode: 691012365
CountryCode: US
TelephoneNumber: 3085320587
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/14/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X1739NEY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


Home