Amy E Cavanaugh PHD LLC

Organization Active NPI Clinical Psychologist · Lafayette, LA

NPI 1992025720 · NPPES record last updated Jul 29, 2014

Key facts

NPI
1992025720
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Psychologist 103TC0700X
Legal business name
AMY E CAVANAUGH PHD LLC
Practice address
4540 Ambassador Caffery Pkwy Ste C200
Lafayette, LA 70508-6930
Phone
(337) 889-5830
Fax
(337) 889-5834
NPI assigned
Jun 3, 2010
Organization subpart
No

Authorized official

Name
Amy E Cavanaugh
Title
Officer
Phone
(337) 889-5830

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140423001031 LA Part B Supplier - Clinic/Group Practice 2860625050 Receives reassigned benefits from 1 practitioner
Practice locations: Lafayette, LA

National Provider Directory

Locations

93 Magnate Dr
Lafayette, LA 70508
Phone (337) 806-9601

4500 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 521-9100

4540 Ambassador Caffery Pkwy
Ste C200
Lafayette, LA 70508
Phone (337) 889-5830

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist
Group: 193400000X SINGLE SPECIALTY GROUP
103TC0700X Yes

Addresses

Primary practice location

4540 Ambassador Caffery Pkwy Ste C200
Lafayette, LA 70508-6930

Mailing address

PO Box 80853
Lafayette, LA 70598-0853
Phone (337) 889-5830

Other providers in Lafayette, LA

All providers in Lafayette, LA · Clinical Psychologist in Louisiana

Sources for this page

Verify at the official NPI Registry.