Provider Demographics
NPI:1780551366
Name:SUTTON, LEVI EUGENE
Entity type:Individual
Prefix:MR
First Name:LEVI
Middle Name:EUGENE
Last Name:SUTTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 SPENCER ST
Mailing Address - Street 2:
Mailing Address - City:LOGANSPORT
Mailing Address - State:IN
Mailing Address - Zip Code:46947-3583
Mailing Address - Country:US
Mailing Address - Phone:574-835-3981
Mailing Address - Fax:
Practice Address - Street 1:719 SPENCER ST
Practice Address - Street 2:
Practice Address - City:LOGANSPORT
Practice Address - State:IN
Practice Address - Zip Code:46947-3583
Practice Address - Country:US
Practice Address - Phone:574-835-3981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
INBACB1414848OtherBACB