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General NPI Number Information
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NPI Number | 1801193131
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Entity Type | Organization
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Legal Business Name | JOANNE KACHMAR LEAVITT, LCSW
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Dates
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Enumeration Date | 02/23/2011
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Last Update Date | 02/23/2011
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Provider Practice Location Address
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Address Line | 7120 BOBALINK CT
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City | LAKE WORTH
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State | FL
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Zip | 33467-1305
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Country | US
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Telephone | 561-968-8361
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Fax |
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Provider Business Mailing Address
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Address Line | 7120 BOBALINK CT
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City | LAKE WORTH
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State | FL
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Zip | 33467-1305
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Country | US
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Telephone | 561-968-8361
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOAL WORKER
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Name | MRS. JOANNE KACHMAR LEAVITT
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Credential | MSW
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Telephone | 561-968-8361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | SW2509
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License Number State | FL
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