1992786206 NPI number — DR. JANET A. LEVENSON PSY.D.

Table of content: DR. JANET A. LEVENSON PSY.D. (NPI 1992786206)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992786206 NPI number — DR. JANET A. LEVENSON PSY.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEVENSON
Provider First Name:
JANET
Provider Middle Name:
A.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSY.D.
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:
1992786206
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
488 E DUNBARTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GOFFSTOWN
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03045-2817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-497-3268
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
722 ROUTE 3A
Provider Second Line Business Practice Location Address:
SUITE 16
Provider Business Practice Location Address City Name:
BOW
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03304-4010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-230-9444
Provider Business Practice Location Address Fax Number:
603-228-9990
Provider Enumeration Date:
11/14/2005

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: 103TC0700X , with the licence number:  757 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0608026Y0NH04 . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30422512 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: H016473 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 412167 . This is a "MAGELLAN" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




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