Provider Demographics
NPI:1235311739
Name:LEVENSON, JUDITH HUTTON (LMHC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:HUTTON
Last Name:LEVENSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:V
Other - Last Name:HUTTON LEVENSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:4510 THACKERAY PL NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4842
Mailing Address - Country:US
Mailing Address - Phone:208-221-3026
Mailing Address - Fax:
Practice Address - Street 1:4510 THACKERAY PL NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4842
Practice Address - Country:US
Practice Address - Phone:208-221-3026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60634360101YM0800X
IDLMFT-4102106H00000X
IDLPC-3843101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional