Provider Demographics
NPI:1639821713
Name:LEVEL UP THERAPY, LLC
Entity Type:Organization
Organization Name:LEVEL UP THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MEGANNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-214-1282
Mailing Address - Street 1:715 KENSINGTON AVE STE 14
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-5700
Mailing Address - Country:US
Mailing Address - Phone:406-214-1282
Mailing Address - Fax:
Practice Address - Street 1:715 KENSINGTON AVE STE 14
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-5700
Practice Address - Country:US
Practice Address - Phone:406-214-1282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health