Provider Demographics
NPI:1982609400
Name:LEVY, ELIZABETH (PHD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:9701 BRODIE LN
Mailing Address - Street 2:STE 205
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-6282
Mailing Address - Country:US
Mailing Address - Phone:512-420-8444
Mailing Address - Fax:512-233-2961
Practice Address - Street 1:9701 BRODIE LN
Practice Address - Street 2:STE 205
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-6282
Practice Address - Country:US
Practice Address - Phone:512-420-8444
Practice Address - Fax:512-233-2961
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX30923103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031507901Medicaid
TX031507902Medicaid