Uptown Counseling Center LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1375 Issued in LA

Legal business name

UPTOWN COUNSELING CENTER LLC

Practice address

400 Mariners Plaza Dr
Suite 830
Mandeville, LA 70448-4798

Phone

(504) 232-7338

Fax

(504) 323-1992

NPI assigned

Nov 18, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Leo Joseph Burke III, MP

Title

Medical Psychologist

Phone

(504) 232-7338

Specialties & licenses 5

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479427200000",
    "number": "1639612948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MARINERS PLAZA DR",
            "address_2": "SUITE 830",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704484798",
            "telephone_number": "504-232-7338",
            "fax_number": "504-323-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MARINERS PLAZA DR",
            "address_2": "SUITE 830",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704484798",
            "telephone_number": "504-232-7338",
            "fax_number": "504-323-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPTOWN COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-18",
        "last_updated": "2016-11-18",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "LEO",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "MEDICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "504-232-7338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC004513",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC004513",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "LA",
            "license": "1375",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "LA",
            "license": "1375",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "LA",
            "license": "MP304056",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Clinical Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.