Provider Demographics
NPI:1235763210
Name:LEVERETTE, MARQUITA D (LCSW)
Entity Type:Individual
Prefix:
First Name:MARQUITA
Middle Name:D
Last Name:LEVERETTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6155 OAK ST STE B
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-2266
Mailing Address - Country:US
Mailing Address - Phone:816-607-3091
Mailing Address - Fax:816-494-1952
Practice Address - Street 1:6155 OAK ST STE B
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64113-2266
Practice Address - Country:US
Practice Address - Phone:816-607-3091
Practice Address - Fax:816-494-1952
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190361591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical