Provider Demographics
NPI:1740460559
Name:LEVENDIS, NICKI MARIA (LPC, MFT)
Entity type:Individual
Prefix:
First Name:NICKI
Middle Name:MARIA
Last Name:LEVENDIS
Suffix:
Gender:F
Credentials:LPC, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 RUE LEMANS
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-2024
Mailing Address - Country:US
Mailing Address - Phone:504-464-5969
Mailing Address - Fax:504-464-5969
Practice Address - Street 1:17 RUE LEMANS
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2024
Practice Address - Country:US
Practice Address - Phone:504-464-5969
Practice Address - Fax:504-464-5969
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2290101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA293060OtherMAGELLAN