Provider Demographics
NPI:1134564339
Name:MCDERMOTT, WILLIAM V (PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:V
Last Name:MCDERMOTT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BOURBON ST # B-430
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70116-2708
Mailing Address - Country:US
Mailing Address - Phone:504-710-0787
Mailing Address - Fax:
Practice Address - Street 1:400 POYDRAS ST
Practice Address - Street 2:SUITE 1780
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-3245
Practice Address - Country:US
Practice Address - Phone:504-322-3837
Practice Address - Fax:504-322-3847
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1237103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical