Healthcare Provider Details

I. General information

NPI: 1912607755
Provider Name (Legal Business Name): KARMYN LATRECE LEVY MA; PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2023
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 LAFAYETTE ST STE 140B
GRETNA LA
70053-5762
US

IV. Provider business mailing address

13170 DUTCHTOWN POINT AVE APT 1724
GONZALES LA
70737-0106
US

V. Phone/Fax

Practice location:
  • Phone: 504-533-9152
  • Fax: 504-533-9154
Mailing address:
  • Phone: 225-623-9625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC8330
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberPLC8330
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberPLC8330
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPLC8330
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: