Provider Demographics
NPI:1235859935
Name:LEVY, KRISTEN DONNA (MS)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:DONNA
Last Name:LEVY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5655 WOODLAND SAGE DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-3518
Mailing Address - Country:US
Mailing Address - Phone:330-483-2617
Mailing Address - Fax:
Practice Address - Street 1:1107 E SILVER SPRINGS BLVD STE 4
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-8701
Practice Address - Country:US
Practice Address - Phone:352-203-0357
Practice Address - Fax:844-289-0968
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19014101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health