MEDICARE: LINDA LEVASSEUR LMHC

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
1	101YM0800X	Mental Health Counselor	MH10532	FL

General Provider Information

NPI Number	:	1518253798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA LEVASSEUR LMHC

Provider Business Mailing Address
First Line	:	224 MAPLE TER
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33325-6752
Country	:	US
Telephone Number	:	954-479-2767
Fax Number	:

Provider Business Practice Location Address
First Line	:	8201 PETERS RD
Second Line	:	SUITE 1000
City	:	PLANTATION
State	:	FL
Zip	:	33324-3265
Country	:	US
Telephone Number	:	954-479-2767
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2011
Last Update Date	:	06/25/2011

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