Provider Demographics
NPI:1982201083
Name:JENNIFER LEVART
Entity Type:Organization
Organization Name:JENNIFER LEVART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-685-9628
Mailing Address - Street 1:2050 FIELDS CV
Mailing Address - Street 2:
Mailing Address - City:PEA RIDGE
Mailing Address - State:AR
Mailing Address - Zip Code:72751-3529
Mailing Address - Country:US
Mailing Address - Phone:479-685-9628
Mailing Address - Fax:
Practice Address - Street 1:2050 FIELDS CV
Practice Address - Street 2:
Practice Address - City:PEA RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72751-3529
Practice Address - Country:US
Practice Address - Phone:479-685-9628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty