Provider Demographics
NPI:1811905995
Name:LEVASSEUR, KEITH (LCPC)
Entity type:Individual
Prefix:MR
First Name:KEITH
Middle Name:
Last Name:LEVASSEUR
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 IROQUOIS AVE STE 145
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1389
Mailing Address - Country:US
Mailing Address - Phone:630-305-0464
Mailing Address - Fax:630-305-0211
Practice Address - Street 1:1300 IROQUOIS AVE STE 145
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1389
Practice Address - Country:US
Practice Address - Phone:630-305-0464
Practice Address - Fax:630-305-0211
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-001646101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232926OtherBCBS PROVIDER #