Clint Harvey
Individual provider Active NPI Mental Health Counselor · Fairfield, IL
NPI 1972791689 · NPPES record last updated Oct 9, 2007
Key facts
- NPI
- 1972791689
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 407 North Basin Road
Fairfield, IL 62837 - Phone
- (618) 842-2125
- Fax
- (618) 842-4154
- NPI assigned
- Oct 9, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
407 North Basin Road
Fairfield, IL 62837
Mailing address
PO Box M
504 Micah Drive
Olney, IL 62450-0913
Phone (618) 395-4306
Other providers in Fairfield, IL
- Dana Lynn Gilbert
- Lauren Griswold
- Francis Guerra-Bauman
- Bryce Michael Harrison
- Michaela Blaire Harrison
- Kathy Hatton
- Deana Lynne Hawkins
- Ross Herdes
- Highland Park CVS, L.L.C.
- Kathie L Hill
All providers in Fairfield, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.