Provider Demographics
NPI:1487861852
Name:LEVITT, MARY-MICHAEL (EDS, LMFT, LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARY-MICHAEL
Middle Name:
Last Name:LEVITT
Suffix:
Gender:F
Credentials:EDS, LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 POWHATATAN WAY
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2648
Mailing Address - Country:US
Mailing Address - Phone:908-850-5778
Mailing Address - Fax:
Practice Address - Street 1:43 POWHATATAN WAY
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2648
Practice Address - Country:US
Practice Address - Phone:908-850-5778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00213500101YP2500X
NJ37F100153100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37PC00213500OtherLPC LICENSE NUMBER
NJ37F100153100OtherLMFT LICENSE