Provider Demographics
NPI:1912607755
Name:LEVY, KARMYN LATRECE (MA; PLPC)
Entity type:Individual
Prefix:MRS
First Name:KARMYN
Middle Name:LATRECE
Last Name:LEVY
Suffix:
Gender:F
Credentials:MA; PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13170 DUTCHTOWN POINT AVE APT 1724
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-0106
Mailing Address - Country:US
Mailing Address - Phone:225-623-9625
Mailing Address - Fax:
Practice Address - Street 1:1500 LAFAYETTE ST STE 140B
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-5762
Practice Address - Country:US
Practice Address - Phone:504-533-9152
Practice Address - Fax:504-533-9154
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC8330101YM0800X, 101YS0200X, 261QM0801X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101Y00000XBehavioral Health & Social Service ProvidersCounselor