Provider Demographics
NPI:1578765020
Name:LEVENSON, LEAH SHARON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:SHARON
Last Name:LEVENSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4044 BEACON AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-9826
Mailing Address - Country:US
Mailing Address - Phone:228-265-5144
Mailing Address - Fax:228-233-3693
Practice Address - Street 1:1508 GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3826
Practice Address - Country:US
Practice Address - Phone:228-265-5144
Practice Address - Fax:228-233-3693
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS47-813103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist