Healthcare Provider Details

I. General information

NPI: 1053621524
Provider Name (Legal Business Name): KRISTIN ELIZABETH LEVANDOSKI M.S, LPC, CAC-D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2010
Last Update Date: 10/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 N WASHINGTON AVE SUITE 601
SCRANTON PA
18503-1549
US

IV. Provider business mailing address

327 N WASHINGTON AVE SUITE 601
SCRANTON PA
18503-1549
US

V. Phone/Fax

Practice location:
  • Phone: 570-909-9324
  • Fax: 570-909-9325
Mailing address:
  • Phone: 570-909-9324
  • Fax: 570-909-9325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC003856
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: