Michael D Chafetz PHD LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

762 Issued in LA

Legal business name

MICHAEL D CHAFETZ PHD LLC

Practice address

3520 General Degaulle Dr
Ste 3044
New Orleans, LA 70114-6757

Phone

(336) 659-8536

NPI assigned

Jul 14, 2008

Last updated

Mar 14, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Kathy Montgomery

Title

Business Manager

Phone

(336) 659-9440

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394755200000",
    "number": "1902060585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 GENERAL DEGAULLE DR",
            "address_2": "STE 3044",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701146757",
            "telephone_number": "336-659-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 GENERAL DEGAULLE DR",
            "address_2": "STE 3044",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701146757",
            "telephone_number": "336-659-8536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D CHAFETZ PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-14",
        "last_updated": "2014-03-14",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "336-659-9440",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "LA",
            "license": "762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1695513",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Clinical Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; 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.