Provider Demographics
NPI:1679963938
Name:ORR, LOUIS L IV (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:L
Last Name:ORR
Suffix:IV
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 1:2804 W MARC KNIGHTON CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34461-8334
Mailing Address - Country:US
Mailing Address - Phone:352-746-8067
Mailing Address - Fax:352-746-8069
Practice Address - Street 1:2804 W MARC KNIGHTON CT
Practice Address - Street 2:SUITE A
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-8334
Practice Address - Country:US
Practice Address - Phone:352-746-8067
Practice Address - Fax:352-746-8069
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 9217103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist