Provider Demographics
NPI:1902920192
Name:LEVASSEUR, CLIFFORD (CAC)
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:
Last Name:LEVASSEUR
Suffix:
Gender:M
Credentials:CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:497 BELLEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02746-2420
Mailing Address - Country:US
Mailing Address - Phone:508-991-7487
Mailing Address - Fax:508-997-2677
Practice Address - Street 1:497 BELLEVILLE AVE
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02746-2420
Practice Address - Country:US
Practice Address - Phone:508-991-7487
Practice Address - Fax:508-997-2677
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA448101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)