Provider Demographics
NPI:1932570215
Name:LEVESQUE, LAUREN (MA, BCBA, LPC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:LEVESQUE
Suffix:
Gender:F
Credentials:MA, BCBA, LPC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:VIEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:7814 SW 189TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-7614
Mailing Address - Country:US
Mailing Address - Phone:808-990-3022
Mailing Address - Fax:
Practice Address - Street 1:4855 SW WESTERN AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3460
Practice Address - Country:US
Practice Address - Phone:800-813-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10191008103K00000X
ORC5386101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst