Provider Demographics
NPI:1942668892
Name:LEVIS THERAPY, A MARRIAGE AND FAMILY THERAPY CORPORATION
Entity Type:Organization
Organization Name:LEVIS THERAPY, A MARRIAGE AND FAMILY THERAPY CORPORATION
Other - Org Name:LEVIS THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAJANI
Authorized Official - Middle Name:VENKATRAMAN
Authorized Official - Last Name:LEVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-683-1008
Mailing Address - Street 1:PO BOX 318003
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-8003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1246 CASTRO ST
Practice Address - Street 2:APT 2
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-3265
Practice Address - Country:US
Practice Address - Phone:415-683-1008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-07
Last Update Date:2016-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 51494106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty