Healthcare Provider Details

I. General information

NPI: 1720917685
Provider Name (Legal Business Name): LEVELING UP LICENSED MARRIAGE AND FAMILY THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3310 CHURN CREEK RD STE A
REDDING CA
96002-2502
US

IV. Provider business mailing address

PO BOX 491827
REDDING CA
96049-1827
US

V. Phone/Fax

Practice location:
  • Phone: 530-710-8963
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNA ANDREWS
Title or Position: OWNER/CEO
Credential:
Phone: 530-710-8963