Provider Demographics
NPI:1750862868
Name:AMY MEREDITH, PSY.D., LLC
Entity Type:Organization
Organization Name:AMY MEREDITH, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEREDITH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:985-249-9469
Mailing Address - Street 1:206 S TYLER ST STE B
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-3073
Mailing Address - Country:US
Mailing Address - Phone:985-249-9469
Mailing Address - Fax:985-792-3106
Practice Address - Street 1:206 S TYLER ST STE B
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3073
Practice Address - Country:US
Practice Address - Phone:985-249-9469
Practice Address - Fax:985-792-3106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1329261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)