Provider Demographics
NPI:1669452827
Name:LEVERINGTON, PAUL T (LCSW)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:T
Last Name:LEVERINGTON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1239 E PORTLAND ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-1125
Mailing Address - Country:US
Mailing Address - Phone:417-885-9940
Mailing Address - Fax:
Practice Address - Street 1:1909 E BENNETT ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1419
Practice Address - Country:US
Practice Address - Phone:417-885-9940
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0036901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical