Provider Demographics
NPI:1932337623
Name:LEWIS, COURTNEY ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:ANN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HENRY CLAY AVE
Mailing Address - Street 2:DEPARTMENT OF PSYCHOLOGY
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5720
Mailing Address - Country:US
Mailing Address - Phone:504-896-9484
Mailing Address - Fax:504-896-5115
Practice Address - Street 1:200 HENRY CLAY AVE
Practice Address - Street 2:DEPARTMENT OF PSYCHOLOGY
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5720
Practice Address - Country:US
Practice Address - Phone:504-896-9484
Practice Address - Fax:504-896-5115
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1195103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA721304948Medicaid