Provider Demographics
NPI:1083025704
Name:LEVITT, ELENA ANN
Entity Type:Individual
Prefix:MS
First Name:ELENA
Middle Name:ANN
Last Name:LEVITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:ANN
Other - Last Name:CAMPISI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SWI
Mailing Address - Street 1:109 RIVIERA PKWY
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-6116
Mailing Address - Country:US
Mailing Address - Phone:631-412-5512
Mailing Address - Fax:
Practice Address - Street 1:11 ROUTE 111
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3739
Practice Address - Country:US
Practice Address - Phone:631-920-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker