Provider Demographics
NPI:1720320302
Name:LEVERT, DAVID MICHAEL (LCSW-C)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MICHAEL
Last Name:LEVERT
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4985 LORDS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:MD
Mailing Address - Zip Code:21822-2279
Mailing Address - Country:US
Mailing Address - Phone:410-366-0259
Mailing Address - Fax:410-219-2666
Practice Address - Street 1:540 RIVERSIDE DR
Practice Address - Street 2:SUITE 7
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5352
Practice Address - Country:US
Practice Address - Phone:443-366-0259
Practice Address - Fax:410-219-2666
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD064633400Medicaid