Provider Demographics
NPI:1447310214
Name:CROUCH, LEAH JEANETTE (PSYD)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:JEANETTE
Last Name:CROUCH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 TULANE AVE
Mailing Address - Street 2:TW22
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-2300
Mailing Address - Fax:504-988-3969
Practice Address - Street 1:1440 CANAL ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2703
Practice Address - Country:US
Practice Address - Phone:504-988-5405
Practice Address - Fax:504-988-4270
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1123103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD742LMedicare ID - Type Unspecified
MD609550001Medicaid
MD259147000OtherMAGELLAN GROUP NATIONAL
517251OtherUHC MAMSI GROUP #
MDLM49EAOtherCAREFIRST BCBS GROUP
DCR968OtherCAREFIRST FEDERAL GROUP