Provider Demographics
NPI:1699703223
Name:LEVY, JUDITH PARKS (PHD, MP)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:PARKS
Last Name:LEVY
Suffix:
Gender:F
Credentials:PHD, MP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10630 N OAK HILLS PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2859
Mailing Address - Country:US
Mailing Address - Phone:225-763-6300
Mailing Address - Fax:225-763-9358
Practice Address - Street 1:10630 N OAK HILLS PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2859
Practice Address - Country:US
Practice Address - Phone:225-763-6300
Practice Address - Fax:225-763-9358
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA976MP103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical