| Judyth A. Leavitt Psychotherapist P.l.l.c. | |
|
100 Emerald St Ste C Keene NH 03431-3610 | |
| (603) 903-2122 | |
| Not Available |
| Full Name | Judyth A. Leavitt Psychotherapist P.l.l.c. |
|---|---|
| Speciality | Counselor |
| Location | 100 Emerald St, Keene, New Hampshire |
| Authorized Official Name and Position | Judyth A Leavitt (CEO) |
| Authorized Official Contact | 6039032122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Judyth A. Leavitt Psychotherapist P.l.l.c. Po Box 384 Keene NH 03431-0384 Ph: (603) 903-2122 | Judyth A. Leavitt Psychotherapist P.l.l.c. 100 Emerald St Ste C Keene NH 03431-3610 Ph: (603) 903-2122 |
| NPI Number | 1083008312 |
|---|---|
| Provider Enumeration Date | 03/25/2015 |
| Last Update Date | 03/25/2015 |
| Medicare PECOS PAC ID | 5799076444 |
|---|---|
| Medicare Enrollment ID | O20160628000396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083008312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0631 (New Hampshire) | Primary |
| 1041C0700X | Social Worker - Clinical | 1514 (New Hampshire) | Secondary |
| Provider Name | Judyth A. Leavitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083927198 PECOS PAC ID: 6608167358 Enrollment ID: I20160628000496 |
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