Provider Demographics
NPI:1124425913
Name:JAMES LEVINE & ASSOCIATES
Entity type:Organization
Organization Name:JAMES LEVINE & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PASTERCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-534-7400
Mailing Address - Street 1:9 COLLEGE ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SOUTH HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075-1148
Mailing Address - Country:US
Mailing Address - Phone:413-534-7400
Mailing Address - Fax:413-534-7483
Practice Address - Street 1:9 COLLEGE ST
Practice Address - Street 2:SUITE 6
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075-1148
Practice Address - Country:US
Practice Address - Phone:413-534-7400
Practice Address - Fax:413-534-7483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7295103TC0700X
MA1168101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty