Provider Demographics
NPI:1902017114
Name:NEVIN, DORIS EILEEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:EILEEN
Last Name:NEVIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 LIVE OAK DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3903
Mailing Address - Country:US
Mailing Address - Phone:540-354-6174
Mailing Address - Fax:
Practice Address - Street 1:1602 W PINHOOK RD STE 303
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3735
Practice Address - Country:US
Practice Address - Phone:337-534-4214
Practice Address - Fax:337-484-1405
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1431103T00000X
VA0810000245103TC1900X, 103TF0200X
NMPSY-RXP0058103TP0016X
LA321261103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic