Provider Demographics
NPI:1922753805
Name:LEVISON, TONIA ROSE (LPC)
Entity Type:Individual
Prefix:
First Name:TONIA
Middle Name:ROSE
Last Name:LEVISON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:857 DUKE DR
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63130-3628
Mailing Address - Country:US
Mailing Address - Phone:314-312-3317
Mailing Address - Fax:
Practice Address - Street 1:9433 OLIVE BLVD
Practice Address - Street 2:
Practice Address - City:OLIVETTE
Practice Address - State:MO
Practice Address - Zip Code:63132-3132
Practice Address - Country:US
Practice Address - Phone:314-312-3317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-18
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019029613101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health