Provider Demographics
NPI:1811261670
Name:LEVITT, KRISTEN MULHEREN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:MULHEREN
Last Name:LEVITT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 INDUSTRIAL WAY W
Mailing Address - Street 2:SUITE A104
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-4244
Mailing Address - Country:US
Mailing Address - Phone:732-977-3547
Mailing Address - Fax:
Practice Address - Street 1:234 INDUSTRIAL WAY W
Practice Address - Street 2:SUITE A104
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-4244
Practice Address - Country:US
Practice Address - Phone:732-977-3547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-26
Last Update Date:2012-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052484001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical