Provider Demographics
NPI:1790224848
Name:BEZDEK, MICHAEL TODD (PLPC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:TODD
Last Name:BEZDEK
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 PERRIER ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-2928
Mailing Address - Country:US
Mailing Address - Phone:225-278-3707
Mailing Address - Fax:
Practice Address - Street 1:4038 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6021
Practice Address - Country:US
Practice Address - Phone:504-681-7030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6549101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor