MEDICARE: LAUREN ELIZABETH LEVESQUE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1841122173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ELIZABETH LEVESQUE

Provider Business Mailing Address
First Line	:	63 BROOKVIEW AVE
Second Line	:
City	:	WALLINGFORD
State	:	CT
Zip	:	06492-2823
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3074 WHITNEY AVE BLDG 3
Second Line	:
City	:	HAMDEN
State	:	CT
Zip	:	06518-2391
Country	:	US
Telephone Number	:	855-444-5664
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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