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Organization
STACI LEAVITT MIND & BODY INC
Active
Organization
STACI LEAVITT MIND & BODY INC
Active
Other names
Staci Leavitt Mind & Body Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MISS STACI LEAVITT DAVIDSON RD (PRESIDENT)
(516) 433-1456
Entity
Organization
Contact information
Practice address
27 MCGOVERN DR, MELVILLE, NY 11747-4258
(516) 433-1456
Mailing address
27 MCGOVERN DR, MELVILLE, NY 11747-4258
(516) 433-1456
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
133V00000X
Registered Dietitian
Primary
—
—
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
—
—
171400000X
Health & Wellness Coach
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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