Michael Roland Leveque, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2012001790 Issued in MO

Practice address

600 S Taylor Ave
Dept Psychiatry, Ste 122
Saint Louis, MO 63110-1035

Phone

(314) 286-1700

Fax

(314) 362-7017

NPI assigned

Mar 6, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Curators of the University of Missouri

  • Community/Behavioral Health Agency
  • Town and Country, MO
  • NPI 1730695362

  Clinical

  NPD (past) Authorized official

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1841531548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S TAYLOR AVE",
            "address_2": "DEPT PSYCHIATRY, STE 122",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101035",
            "telephone_number": "314-286-1700",
            "fax_number": "314-362-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S TAYLOR AVE",
            "address_2": "DEPT PSYCHIATRY, STE 122",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101035",
            "telephone_number": "314-286-1700",
            "fax_number": "314-362-7017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVEQUE",
        "first_name": "MICHAEL",
        "middle_name": "ROLAND",
        "name_prefix": "Mr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-06",
        "last_updated": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2012001790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490025973",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "600 S Taylor Ave",
            "address_2": "Dept Psychiatry, Ste 122",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Level Up Counseling
• Kimberly Diane Levenhagen, DPT
• Debra Levens, MSW, LCSW
• Lawrence Jay Levens, DDS, MS, PC
• Nicholas Jay Levensailor, AA
• Nicholas Richard Levergood, MD
• Amanda Kristine Levett, MS, CCC-SLP
• Gretchen Hollrah Levey, M.D.
• Alan Samuel Levi, PHD DMD
• Alexander Levin, DDS

• Clinical Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.