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General NPI Number Information
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NPI Number | 1417398579
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Entity Type | Individual
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Provider Name | LEVAUGHN WESTBROOK LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/17/2013
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Last Update Date | 07/03/2019
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Provider Practice Location Address
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Address Line | 1537 N LEROY ST
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City | FENTON
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State | MI
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Zip | 48430-2795
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Country | US
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Telephone | 703-782-9298
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Fax |
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Provider Business Mailing Address
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Address Line | 11426 DAVIS ST UNIT 1032
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City | GRAND BLANC
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State | MI
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Zip | 48480-8542
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Country | US
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Telephone | 703-782-9298
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904009408
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801096198
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License Number State | MI
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