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General NPI Number Information
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NPI Number | 1083376321
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Entity Type | Individual
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Provider Name | JENNIE LYNNE LEVAK LPCC
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Gender | Female
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Dates
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Enumeration Date | 10/13/2021
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 771 N FREEDOM ST
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City | RAVENNA
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State | OH
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Zip | 44266-2470
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Country | US
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Telephone | 330-296-5552
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Fax |
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Provider Business Mailing Address
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Address Line | 140 KENDALL PARK RD
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City | PENINSULA
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State | OH
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Zip | 44264-9720
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Country | US
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Telephone | 330-926-7247
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Fax |
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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 | E.2505156
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License Number State | OH
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