Provider Demographics
NPI:1417398579
Name:WESTBROOK, LEVAUGHN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:LEVAUGHN
Middle Name:
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11426 DAVIS ST UNIT 1032
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48480-8542
Mailing Address - Country:US
Mailing Address - Phone:703-782-9298
Mailing Address - Fax:
Practice Address - Street 1:1537 N LEROY ST
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-2795
Practice Address - Country:US
Practice Address - Phone:703-782-9298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040094081041C0700X
MI68010961981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty