Doctor Name: | DR. TERRY MICHAEL LEVY |
NPI Number: | 1073680948 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 1822 |
Business Practice Address: | 32065 Castle Ct Ste 325 Evergreen Psychotherapy Ctr Evergreen, CO - 80439 |
Business Phone Number: | 3036744029 |
Business Fax Number: | 3036744078 |
Mailing Address: | 32065 Castle Ct, Ste 325 Evergreen Psychotherapy Ctr EVERGREEN |
State: | CO |
Postal Code: | 80439 |
Phone Number: | 3036744029 |
Fax Number: | 3036744078 |
NPI Enumeration Date: | 11/29/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1822 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |