Five Journeys Referrals

Referrals from
Five Journeys

Please fill out the form completely and plan accordingly as it may take up to two weeks to obtain a referral. Thank you.
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Referrals to Five Journeys

To request a referral from your PCP to see our medical providers, please provide them with the following information.

Please fax the information to 617-934-6401.

If we do not receive this information before your first appointment, you will be charged for the visit and then reimbursed when the referral arrives. Thank you.

PLEASE INCLUDE:
  • The date of your first appointment
  • Number of visits – 12
  • The reason for your visit
  •  Our Fax # 617-934-6401
The name and NPI# of your provider:
  • Edward Levitan, MD – NPI# 1740393222
  • Wendie Trubow, MD – NPI# 1730258237
  • Marinela Lavena, MD – NPI# 1760647770
  • Beth Galan, NP – NPI# 1376850149
  • Carolyn Gillespie, NP – NPI# 1831800188