Individual
MITCHELL A LEVICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
9201 MONTGOMERY BLVD NE BLDG 1, ALBUQUERQUE, NM 87111-2468
(505) 342-0400
Mailing address
PO BOX 20848, ALBUQUERQUE, NM 87154-0848
(505) 342-0400
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
638
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P0269
—
NM
Enumeration date
03/29/2006
Last updated
04/11/2023
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