Provider Demographics
NPI:1790002699
Name:LEVERE, BLANCHE (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:BLANCHE
Middle Name:
Last Name:LEVERE
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2972
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08543-2972
Mailing Address - Country:US
Mailing Address - Phone:609-394-0401
Mailing Address - Fax:609-394-0045
Practice Address - Street 1:320 W STATE ST
Practice Address - Street 2:SUITE #2
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-5704
Practice Address - Country:US
Practice Address - Phone:609-394-0401
Practice Address - Fax:609-394-0045
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-01
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLMFT000109106H00000X
NJLCPC064-3684101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral