Provider Demographics
NPI:1851463889
Name:PSYCHOLOGICAL INSIGHT LLC
Entity Type:Organization
Organization Name:PSYCHOLOGICAL INSIGHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:N
Authorized Official - Last Name:LERAY
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:337-593-0830
Mailing Address - Street 1:234 RUE BEAUREGARD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3399
Mailing Address - Country:US
Mailing Address - Phone:337-593-0830
Mailing Address - Fax:337-593-0122
Practice Address - Street 1:234 RUE BEAUREGARD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3399
Practice Address - Country:US
Practice Address - Phone:337-593-0830
Practice Address - Fax:337-593-0122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA514103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1191230Medicaid
LA5CK81Medicare PIN