Organization
UPTOWN COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEO JOSEPH BURKE III MP (MEDICAL PSYCHOLOGIST)
(504) 232-7338
Entity
Organization
Contact information
Practice address
400 MARINERS PLAZA DR, SUITE 830, MANDEVILLE, LA 70448-4798
(504) 232-7338
(504) 323-1992
Mailing address
400 MARINERS PLAZA DR, SUITE 830, MANDEVILLE, LA 70448-4798
(504) 232-7338
(504) 323-1992
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PC004513
PA
101YP2500X
Professional Counselor
PC004513
PA
103TC0700X
Clinical Psychologist
Primary
1375
LA
103TC2200X
Clinical Child & Adolescent Psychologist
1375
LA
103TP0016X
Prescribing (Medical) Psychologist
MP304056
LA
Other
Enumeration date
11/18/2016
Last updated
11/18/2016
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