Provider Demographics
NPI:1871758011
Name:LEVESQUE, SYLVIE ALICIA (LPC)
Entity type:Individual
Prefix:
First Name:SYLVIE
Middle Name:ALICIA
Last Name:LEVESQUE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 COOPER AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:UPPER MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1883
Mailing Address - Country:US
Mailing Address - Phone:201-739-3506
Mailing Address - Fax:973-409-4449
Practice Address - Street 1:209 COOPER AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:UPPER MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1883
Practice Address - Country:US
Practice Address - Phone:201-739-3506
Practice Address - Fax:973-409-4449
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00376600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health