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NPI Code Detail

MEDICARE: EMILY M LEAVITT LCSW

MEDICARE:   EMILY M LEAVITT  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCS10804CA

General Provider Information

NPI Number : 1376618017
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY M LEAVITT LCSW
Provider Business Mailing Address
First Line : PO BOX 7464
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94120-7464
Country : US
Telephone Number : 415-206-3103
Fax Number : 415-206-3872
Provider Business Practice Location Address
First Line : 1930 MARKET STREET
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94102
Country : US
Telephone Number : 415-476-3902
Fax Number : 415-476-3655
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 07/08/2007

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Directions to “ EMILY M LEAVITT LCSW” Practice Location

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