Provider Demographics
NPI:1679843841
Name:LEVEN, EVA (PSYD)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:LEVEN
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 1:304 BUCKINGHAM CIR
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-1958
Mailing Address - Country:US
Mailing Address - Phone:908-720-5956
Mailing Address - Fax:
Practice Address - Street 1:304 BUCKINGHAM CIR
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-1958
Practice Address - Country:US
Practice Address - Phone:908-720-5956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021042103TC0700X
MO2015013944103TC0700X
PAPS018823103TC0700X
IL071009115103TC0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical