Provider Demographics
NPI:1104908656
Name:LEVIN, LAWRENCE MICHAEL (LCSW)
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:MICHAEL
Last Name:LEVIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:LARRY
Other - Middle Name:MICHAEL
Other - Last Name:LEVIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 971
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-0971
Mailing Address - Country:US
Mailing Address - Phone:530-898-9801
Mailing Address - Fax:530-898-8449
Practice Address - Street 1:100 AMBER GROVE LANE
Practice Address - Street 2:SUITE 100
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928
Practice Address - Country:US
Practice Address - Phone:530-898-9801
Practice Address - Fax:530-898-8449
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 221941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical