Provider Demographics
NPI:1174069686
Name:SHAUNTE LEVASSEUR
Entity type:Organization
Organization Name:SHAUNTE LEVASSEUR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUNTE
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:LEVASSEUR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-752-7135
Mailing Address - Street 1:49 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-4832
Mailing Address - Country:US
Mailing Address - Phone:203-752-7135
Mailing Address - Fax:
Practice Address - Street 1:49 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-4832
Practice Address - Country:US
Practice Address - Phone:203-752-7135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC15394101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty