Healthcare Provider Details

I. General information

NPI: 1992786206
Provider Name (Legal Business Name): JANET A. LEVENSON PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 ROUTE 3A SUITE 16
BOW NH
03304-4010
US

IV. Provider business mailing address

488 E DUNBARTON RD
GOFFSTOWN NH
03045-2817
US

V. Phone/Fax

Practice location:
  • Phone: 603-230-9444
  • Fax: 603-228-9990
Mailing address:
  • Phone: 603-497-3268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number757
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: