Provider Demographics
NPI:1548615693
Name:LEVISON, ANCHANESE (LPC)
Entity Type:Individual
Prefix:MS
First Name:ANCHANESE
Middle Name:
Last Name:LEVISON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 JOSEPH E BOONE BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30314-2032
Mailing Address - Country:US
Mailing Address - Phone:678-843-8790
Mailing Address - Fax:404-753-6955
Practice Address - Street 1:1300 JOSEPH E BOONE BLVD NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30314-2032
Practice Address - Country:US
Practice Address - Phone:678-843-8790
Practice Address - Fax:404-753-6955
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00547101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional