Healthcare Provider Details

I. General information

NPI: 1811371040
Provider Name (Legal Business Name): LSL PSYCHOLOGICAL SERVICES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2015
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 GOVERNMENT ST
OCEAN SPRINGS MS
39564-3826
US

IV. Provider business mailing address

4044 BEACON AVE
MONROE NC
28110-9826
US

V. Phone/Fax

Practice location:
  • Phone: 228-265-5144
  • Fax: 228-233-3693
Mailing address:
  • Phone: 228-265-5144
  • Fax: 228-233-3693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. LEAH SHARON LEVENSON
Title or Position: PSYCHOLOGIST/OWNER
Credential: PSY.D.
Phone: 228-265-5144