Provider Demographics
NPI:1679975296
Name:LEVITT, LAURI
Entity Type:Individual
Prefix:
First Name:LAURI
Middle Name:
Last Name:LEVITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 COMPO MILL CV
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-6612
Mailing Address - Country:US
Mailing Address - Phone:203-454-3337
Mailing Address - Fax:
Practice Address - Street 1:54 COMPO MILL CV
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-6612
Practice Address - Country:US
Practice Address - Phone:203-454-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker