Provider Demographics
NPI:1598038796
Name:LEVE, ROBERT MORTON (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MORTON
Last Name:LEVE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:
Other - Last Name:LEVE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 605
Mailing Address - Street 2:
Mailing Address - City:WEST SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06092-0605
Mailing Address - Country:US
Mailing Address - Phone:860-651-7648
Mailing Address - Fax:
Practice Address - Street 1:52 WOODCHUCK HILL RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:CT
Practice Address - Zip Code:06019-2131
Practice Address - Country:US
Practice Address - Phone:860-651-7648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT374103K00000X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst