| Amy E Cavanaugh Phd Llc | |
|
4540 Ambassador Caffery Pkwy Ste C200 Lafayette LA 70508-6930 | |
| (337) 889-5830 | |
| (337) 889-5834 |
| Full Name | Amy E Cavanaugh Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 4540 Ambassador Caffery Pkwy Ste C200, Lafayette, Louisiana |
| Authorized Official Name and Position | Amy E Cavanaugh (OFFICER) |
| Authorized Official Contact | 3378895830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy E Cavanaugh Phd Llc Po Box 80853 Lafayette LA 70598-0853 Ph: (337) 889-5830 | Amy E Cavanaugh Phd Llc 4540 Ambassador Caffery Pkwy Ste C200 Lafayette LA 70508-6930 Ph: (337) 889-5830 |
| NPI Number | 1992025720 |
|---|---|
| Provider Enumeration Date | 06/03/2010 |
| Last Update Date | 07/29/2014 |
| Medicare PECOS PAC ID | 2860625050 |
|---|---|
| Medicare Enrollment ID | O20140423001031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992025720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amy E Cavanaugh |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962554790 PECOS PAC ID: 9436374980 Enrollment ID: I20141117001054 |
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