Provider Demographics
NPI:1285399493
Name:LEVITSKY, ANNE STEWART (LGPC)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:STEWART
Last Name:LEVITSKY
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ANNE
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGPC
Mailing Address - Street 1:15245 SHADY GROVE RD STE 315
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6208
Mailing Address - Country:US
Mailing Address - Phone:240-457-9194
Mailing Address - Fax:
Practice Address - Street 1:2518 OLD COACH CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-9498
Practice Address - Country:US
Practice Address - Phone:304-261-8961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11956101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD15431323OtherCAQH