Provider Demographics
NPI:1376596288
Name:LEVITON, BARBARA (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:LEVITON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 ALAMEDA BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-1937
Mailing Address - Country:US
Mailing Address - Phone:505-897-7883
Mailing Address - Fax:505-792-8578
Practice Address - Street 1:1100 ALAMEDA BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-1937
Practice Address - Country:US
Practice Address - Phone:505-897-7883
Practice Address - Fax:505-792-8578
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM308103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00NM00JK47OtherBLUE CROSS BLUE SHIELD
NM76077522887114A001OtherTRIWEST HEALTHCARE ALLIAN
NM760885228 0001OtherCIGNA HEALTHCARE
NMNM100028Medicaid
NM106500OtherMHN
NM098495OtherVALUE OPTIONS