Provider Demographics
NPI:1023722279
Name:MASTER CLINICIANS LLC
Entity type:Organization
Organization Name:MASTER CLINICIANS 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:
Authorized Official - Last Name:GERVEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, MP
Authorized Official - Phone:908-217-5070
Mailing Address - Street 1:121 METAIRIE LAWN DR STE A
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-5448
Mailing Address - Country:US
Mailing Address - Phone:908-217-5070
Mailing Address - Fax:504-362-2215
Practice Address - Street 1:2401 WESTBEND PKWY STE 4098
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-2470
Practice Address - Country:US
Practice Address - Phone:908-217-5070
Practice Address - Fax:504-362-2215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty