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General NPI Number Information
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NPI Number | 1275078800
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Entity Type | Individual
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Provider Name | LEVI LAFFERTY
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Gender | Male
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Dates
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Enumeration Date | 01/06/2017
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1324 LAKELAND HILLS BLVD
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City | LAKELAND
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State | FL
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Zip | 33805-4543
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Country | US
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Telephone | 863-687-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 2127 UNIVERSITY PARK DR STE 300
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City | OKEMOS
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State | MI
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Zip | 48864-5928
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Country | US
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Telephone |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401222287
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH25005
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License Number State | FL
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