Provider Demographics
NPI:1801241682
Name:LEVITAN, ANDREA HOPE (LPC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:HOPE
Last Name:LEVITAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 W 121ST ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2736
Mailing Address - Country:US
Mailing Address - Phone:816-820-9778
Mailing Address - Fax:
Practice Address - Street 1:6240 W 121ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2736
Practice Address - Country:US
Practice Address - Phone:816-820-9778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2669101YP2500X
MO2014022261101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional