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General NPI Number Information
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NPI Number | 1780850511
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Entity Type | Individual
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Provider Name | DEBRA ELLEN LEVENSELLER LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 325C KENNEDY MEMORIAL DR
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City | WATERVILLE
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State | ME
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Zip | 04901-4517
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Country | US
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Telephone | 207-692-4660
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Fax |
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Provider Business Mailing Address
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Address Line | 44 DIRIGO RD
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City | BELGRADE
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State | ME
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Zip | 04917-3255
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Country | US
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Telephone | 207-692-4660
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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 | LC12752
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License Number State | ME
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