Provider Demographics
NPI:1538829445
Name:HARVEY, BARBARA ANN-BULLOCK (LLMSW)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANN-BULLOCK
Last Name:HARVEY
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ANN-BULLOCK
Other - Last Name:BEATTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26315 BUSTER DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48091-3927
Mailing Address - Country:US
Mailing Address - Phone:248-819-6252
Mailing Address - Fax:586-497-3316
Practice Address - Street 1:624 W NEPESSING ST STE 300
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2089
Practice Address - Country:US
Practice Address - Phone:810-667-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851094633104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker