Provider Demographics
NPI:1124219472
Name:LEVENBERG, STEPHEN BREGSTONE (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:BREGSTONE
Last Name:LEVENBERG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:B
Other - Last Name:LEVENBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:35 WESTHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-3737
Mailing Address - Country:US
Mailing Address - Phone:843-442-4893
Mailing Address - Fax:
Practice Address - Street 1:1001 ANNA KNAPP EXT
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5412
Practice Address - Country:US
Practice Address - Phone:843-442-4893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC755103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical