Provider Demographics
NPI:1144547860
Name:HARVEY, ALICIA K (EDS, LPC-S, RAT-S)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:K
Last Name:HARVEY
Suffix:
Gender:F
Credentials:EDS, LPC-S, RAT-S
Other - Prefix:
Other - First Name:LYSSA
Other - Middle Name:
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5115 FOREST PLAZA
Mailing Address - Street 2:SUITE D
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206
Mailing Address - Country:US
Mailing Address - Phone:803-920-0707
Mailing Address - Fax:803-779-3364
Practice Address - Street 1:5115 FOREST PLAZA SUITE D
Practice Address - Street 2:THE ART AND PLAY THERAPY CENTER OF S.C.
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29206
Practice Address - Country:US
Practice Address - Phone:803-920-0707
Practice Address - Fax:803-779-3364
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC#LPC2326101YP2500X
#94-671221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist