Provider Demographics
NPI:1881313518
Name:4 LEVEL THERAPY, PLLC
Entity type:Organization
Organization Name:4 LEVEL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON DORSETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-433-0201
Mailing Address - Street 1:2819 WRIGHTSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-2549
Mailing Address - Country:US
Mailing Address - Phone:609-433-0201
Mailing Address - Fax:
Practice Address - Street 1:2819 WRIGHTSVILLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2549
Practice Address - Country:US
Practice Address - Phone:609-433-0201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty