Provider Demographics
NPI:1285089391
Name:LEVINE, JANET (LCMHC)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:LEVINE
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5104 REAGAN DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-1396
Mailing Address - Country:US
Mailing Address - Phone:704-438-8962
Mailing Address - Fax:980-938-4984
Practice Address - Street 1:5104 REAGAN DR STE 13
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-1393
Practice Address - Country:US
Practice Address - Phone:980-938-4840
Practice Address - Fax:980-938-4984
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-26
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS22559171W00000X
NC13601101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171W00000XOther Service ProvidersContractor