Healthcare Provider Details

I. General information

NPI: 1851152805
Provider Name (Legal Business Name): LEVIS FAMILY THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2024
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 W RIVERSIDE AVE STE 8319
SPOKANE WA
99201-0580
US

IV. Provider business mailing address

522 W RIVERSIDE AVE STE 8319
SPOKANE WA
99201-0580
US

V. Phone/Fax

Practice location:
  • Phone: 415-683-1008
  • Fax:
Mailing address:
  • Phone: 415-683-1008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. RAJANI V LEVIS
Title or Position: FOUNDER
Credential: MS, MFT, PPS, CTTS
Phone: 415-683-1008