Provider Demographics
NPI:1205442753
Name:LEVENTON, NINA DORIT
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:DORIT
Last Name:LEVENTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BARTON RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-2211
Mailing Address - Country:US
Mailing Address - Phone:203-448-6055
Mailing Address - Fax:
Practice Address - Street 1:105 DANBURY RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4147
Practice Address - Country:US
Practice Address - Phone:203-431-9726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker