Provider Demographics
NPI:1306311089
Name:LEVINSON, CHLOE (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SINKING CAVE RD
Mailing Address - Street 2:
Mailing Address - City:TELLICO PLAINS
Mailing Address - State:TN
Mailing Address - Zip Code:37385-5404
Mailing Address - Country:US
Mailing Address - Phone:520-591-4421
Mailing Address - Fax:
Practice Address - Street 1:4160 OCOEE ST N STE 8
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-4886
Practice Address - Country:US
Practice Address - Phone:423-464-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
AZLPC-17564101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLPC-17564OtherAZ BOARD OF BEHAVIORAL HEALTH EXAMINERS