Barry M Leavitt and Associates
Organization Active NPI Clinical Psychologist · Northfield, IL
NPI 1073840484 · NPPES record last updated Nov 9, 2009
Key facts
- NPI
- 1073840484
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 071003655 (IL)
- Legal business name
- BARRY M LEAVITT AND ASSOCIATES
- Practice address
- 790 Frontage Rd
Northfield, IL 60093-1204 - Phone
- (847) 441-4111
- NPI assigned
- Nov 5, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Barry M Leavitt, PSYD
- Title
- President
- Phone
- (847) 441-4111
Practitioners 1
-
Barry M Leavitt, PSYD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091202000182 | IL | Part B Supplier - Clinic/Group Practice | 0042359283 |
Receives reassigned benefits from 1 practitioner Practice locations: Northbrook, IL |
National Provider Directory
Locations
1500 Skokie Blvd
Ste 315
Northbrook, IL 60062
Phone (847) 849-5553
790 W Frontage Rd
Ste 330
Northfield, IL 60093
Phone (847) 441-4120
790 W Frontage Rd
Northfield, IL 60093
Phone (847) 441-2399
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | 071003655 | IL | Yes |
Addresses
Primary practice location
790 Frontage Rd
Northfield, IL 60093-1204
Mailing address
790 Frontage Rd
Northfield, IL 60093-1204
Phone (847) 441-4111
Other providers in Northfield, IL
- Barbara Mokrzycka-Pys, DC, S.C.
- Amanda Barr
- Freya H Barr
- Leilani Raquel Barrera
- Elizabeth Barrow
- Olivia Bayer
- Nina Becker
- Jeanne D. Beckman
- Cortney Behmer
- Diane Behnke
All providers in Northfield, IL · Clinical Psychologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.