Leavitt, Phyllis E.

Leavitt, Phyllis E. is an individual health care provider with primary practice located at 208 Las Mananitas St , Santa Fe NM 87501-1546. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Leavitt, Phyllis E. can be contacted via phone (505) 986-0756.

Contact Information

Primary practice address
208 Las Mananitas St Santa Fe NM 87501-1546
Phone: (505) 986-0756
Fax: (505) 983-4638
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 1301 New Mexico
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 1835 New Mexico

Profile Details

NPI number 1861460594
LBN Legal business name Leavitt, Phyllis E.
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861460594 NPPES
New Mexico MEDICAID 54108730

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