1255476586 NPI number — MRS. SUZANNE LEVY LESCHT LCSW C

Table of content: MRS. SUZANNE LEVY LESCHT LCSW C (NPI 1255476586)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255476586 NPI number — MRS. SUZANNE LEVY LESCHT LCSW C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LESCHT
Provider First Name:
SUZANNE
Provider Middle Name:
LEVY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255476586
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3647 GROSVENOR DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELLICOTT CITY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-461-1903
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10632 LITTLE PATUXENT PKWY
Provider Second Line Business Practice Location Address:
STE 245
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21044-3273
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-997-1919
Provider Business Practice Location Address Fax Number:
410-997-1993
Provider Enumeration Date:
02/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  10317 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PVPB124752 . This is a "AMERICAN PSYCH SYSTEMS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 281637 . This is a "MAMSI OPTIMUM CHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: H1240004 . This is a "CAREFIRST BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 143680 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 226998 . This is a "MANAGED HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 76938703 . This is a "CAREFIRST BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 254418000 . This is a "MAGELLAN BEHAVIORAL HLTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 486958800 . This is a "FECA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9099704 . This is a "PRIVATE HEALTHCARE SYSTEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 281637 . This is a "MD IPA ALLIANCE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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