Provider Demographics
NPI:1750760641
Name:LEAVELL, KARI (PHD)
Entity type:Individual
Prefix:DR
First Name:KARI
Middle Name:
Last Name:LEAVELL
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 1:1135 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7533
Mailing Address - Country:US
Mailing Address - Phone:817-329-5041
Mailing Address - Fax:844-729-1745
Practice Address - Street 1:1135 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7533
Practice Address - Country:US
Practice Address - Phone:817-329-5041
Practice Address - Fax:844-729-1745
Is Sole Proprietor?:No
Enumeration Date:2015-05-25
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36818103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling