Provider Demographics
NPI:1215313523
Name:MARK LEVINE M.D. MINDFULNESS ASSOCIATES, P.C.
Entity type:Organization
Organization Name:MARK LEVINE M.D. MINDFULNESS ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-902-4976
Mailing Address - Street 1:26645 NORMANDY RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MI
Mailing Address - Zip Code:48025-1033
Mailing Address - Country:US
Mailing Address - Phone:916-241-9496
Mailing Address - Fax:916-436-9055
Practice Address - Street 1:3017 DOUGLAS BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3850
Practice Address - Country:US
Practice Address - Phone:855-500-6463
Practice Address - Fax:844-553-6337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty