Provider Demographics
NPI:1003039702
Name:LEVY, FREDERICK C (PHD LICENSED PSYCHOL)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:C
Last Name:LEVY
Suffix:
Gender:M
Credentials:PHD LICENSED PSYCHOL
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:C
Other - Last Name:LEVY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1908 MICCOSUKEE RD
Mailing Address - Street 2:RICK LEVY PHD
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:850-877-6565
Mailing Address - Fax:850-877-6565
Practice Address - Street 1:1908 MICCOSUKEE RD
Practice Address - Street 2:RICK LEVY PHD
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-877-6565
Practice Address - Fax:850-877-6565
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5075103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist