Eileen Patricia Leveckis, AMFT, APCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

121758 Issued in CA

Practice address

1800 Gravenstein Hwy N
Sebastopol, CA 95472-2607

Phone

(707) 634-9077

NPI assigned

Apr 1, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Siyan Clinical CorporationGroup PAC ID 0042470122, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Siyan Clinical Corporation

  • Psychiatry Physician
  • Santa Rosa, CA
  • NPI 1568732972
  Medicare reassignment Care Compare group NPD
• TLC Child & Family Services

  • Adolescent and Children Mental Health Clinic/Center
  • Sebastopol, CA
  • NPI 1073131942
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1083292833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 GRAVENSTEIN HWY N",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954722607",
            "telephone_number": "707-634-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 GRAVENSTEIN HWY N",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954722607",
            "telephone_number": "707-634-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVECKIS",
        "first_name": "EILEEN",
        "middle_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "AMFT, APCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "8533",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "121758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Sangjae Lee, D.D.S.
• James Andrew Lemesurier, M.D.
• Gillian Lerner, PSYD
• Lesley Cantor a Family Therapy Professional Corporation
• Dana Levandoski, LCSW
• Emilio Licea III, PSYD
• Emily Linders, LMFT
• Michael Jon Lipelt, DDS, ND, L.AC.
• Lips Chiropractic Inc
• Live Oak Rest Home

• Mental Health Counselor in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.