Provider Demographics
NPI:1316271596
Name:LEVIN, ALAN M (MA, LCSW)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:M
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 CRAWFORD AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4970
Mailing Address - Country:US
Mailing Address - Phone:847-209-4440
Mailing Address - Fax:847-328-2908
Practice Address - Street 1:2530 CRAWFORD AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4970
Practice Address - Country:US
Practice Address - Phone:847-209-4440
Practice Address - Fax:847-328-2908
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490162871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical