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Individual

BARDA L. LEAVITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
2 BEECH STREET, UNIT 1A, HALLOWELL, ME 04347-1520
(207) 622-3559
Mailing address
93 SECOND ST, HALLOWELL, ME 04347-1450
(207) 622-3559
(207) 621-0692

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS373
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
005900
ANTHEM BLUE CROSS
01
1036493
CIGNA
01
147311000
MAGELLAN BEHAVIORAL HEALT
05
197300000
ME
01
MNT793
HARVARD PILGRIM
Enumeration date
11/02/2006
Last updated
12/23/2021
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