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General NPI Number Information
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NPI Number | 1083117899
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Entity Type | Individual
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Provider Name | JULIE ADRIENNE LEVESQUE LPC
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Gender | Female
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Dates
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Enumeration Date | 03/18/2018
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Last Update Date | 03/18/2018
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Provider Practice Location Address
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Address Line | 125 MAIN ST N STE 2B
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City | WOODBURY
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State | CT
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Zip | 06798-2953
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Country | US
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Telephone | 203-263-3175
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Fax | 844-364-2702
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Provider Business Mailing Address
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Address Line | 236 WASHINGTON RD
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City | WOODBURY
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State | CT
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Zip | 06798-2807
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Country | US
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Telephone | 203-263-3793
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Fax | 844-364-2702
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3416
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License Number State | CT
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