Provider Demographics
NPI:1982186060
Name:LEVESQUE, ALI A SCHULTZ (MM, MS)
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:A SCHULTZ
Last Name:LEVESQUE
Suffix:
Gender:F
Credentials:MM, MS
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 369
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-0369
Mailing Address - Country:US
Mailing Address - Phone:860-999-3415
Mailing Address - Fax:
Practice Address - Street 1:3840 US HIGHWAY 93 N
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-6526
Practice Address - Country:US
Practice Address - Phone:860-999-3415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health