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General NPI Number Information
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NPI Number | 1578765020
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Entity Type | Individual
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Provider Name | LEAH SHARON LEVENSON PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 1508 GOVERNMENT ST
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3826
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Country | US
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Telephone | 228-265-5144
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Fax | 228-233-3693
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Provider Business Mailing Address
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Address Line | 4044 BEACON AVE
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City | MONROE
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State | NC
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Zip | 28110-9826
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Country | US
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Telephone | 228-265-5144
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Fax | 228-233-3693
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 47-813
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License Number State | MS
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