Provider Demographics
NPI:1912927799
Name:LEVIZON, TERESA M (LPC)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:M
Last Name:LEVIZON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:PROF
Other - First Name:TERESA
Other - Middle Name:M
Other - Last Name:LEVIZON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCC # 47473
Mailing Address - Street 1:111 APPELDOORN CIR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-6104
Mailing Address - Country:US
Mailing Address - Phone:828-277-0858
Mailing Address - Fax:828-658-1270
Practice Address - Street 1:111 APPELDOORN CIRCLE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-6104
Practice Address - Country:US
Practice Address - Phone:828-277-0858
Practice Address - Fax:828-658-1270
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5016101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102965Medicaid
NC14091OtherPROFESSIONAL COUNSELOR