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General NPI Number Information
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NPI Number | 1538107123
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Entity Type | Organization
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Legal Business Name | LAWRENCE J. LEVY, PSY.D., P.A.
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 05/25/2011
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Provider Practice Location Address
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Address Line | 398 CAMINO GARDENS BLVD SUITE 207
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City | BOCA RATON
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State | FL
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Zip | 33432-5827
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Country | US
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Telephone | 561-210-5125
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Fax | 561-210-8802
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Provider Business Mailing Address
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Address Line | PO BOX 720
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City | BOCA RATON
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State | FL
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Zip | 33429-0720
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Country | US
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Telephone | 561-210-5125
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Fax | 561-210-8802
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAWRENCE J LEVY
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Credential | PSY.D.
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Telephone | 561-210-5125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY7159
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License Number State | FL
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