Provider Demographics
NPI:1184991952
Name:LEVINSON, RANDI LISA (MA)
Entity type:Individual
Prefix:MS
First Name:RANDI
Middle Name:LISA
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:RANDI
Other - Middle Name:L
Other - Last Name:GAGNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:607 PLEASANT ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2570
Mailing Address - Country:US
Mailing Address - Phone:508-223-4691
Mailing Address - Fax:508-223-3397
Practice Address - Street 1:607 PLEASANT ST
Practice Address - Street 2:SUITE 115
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2570
Practice Address - Country:US
Practice Address - Phone:508-223-4691
Practice Address - Fax:508-223-3397
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health