Provider Demographics
NPI:1225584279
Name:LEVY, MATTHEW (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 LAKE FORREST DR
Mailing Address - Street 2:SUITE 575
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3824
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6000 LAKE FORREST DR
Practice Address - Street 2:SUITE 575
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3824
Practice Address - Country:US
Practice Address - Phone:404-308-0497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent