Healthcare Provider Details

I. General information

NPI: 1407726490
Provider Name (Legal Business Name): MS. ELIZABETH LEVERING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CAMBRIDGE ST
BOSTON MA
02114-2509
US

IV. Provider business mailing address

99 CHESTNUT HILL AVE APT 202
BRIGHTON MA
02135-3953
US

V. Phone/Fax

Practice location:
  • Phone: 508-296-5631
  • Fax:
Mailing address:
  • Phone: 978-771-6274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: