Provider Demographics
NPI:1114003506
Name:LEVITT, JOEL CHARLES (MFT)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:CHARLES
Last Name:LEVITT
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 JEFFERSON ST
Mailing Address - Street 2:600A
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2442
Mailing Address - Country:US
Mailing Address - Phone:707-258-8353
Mailing Address - Fax:
Practice Address - Street 1:1303 JEFFERSON ST
Practice Address - Street 2:600A
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2442
Practice Address - Country:US
Practice Address - Phone:707-258-8353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 37254101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health