Provider Demographics
NPI:1316748304
Name:LEVITAN, ADINA YEHUDIT (CCLS)
Entity type:Individual
Prefix:
First Name:ADINA
Middle Name:YEHUDIT
Last Name:LEVITAN
Suffix:
Gender:
Credentials:CCLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7362 PARK HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5436
Mailing Address - Country:US
Mailing Address - Phone:410-487-4880
Mailing Address - Fax:
Practice Address - Street 1:7362 PARK HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-5436
Practice Address - Country:US
Practice Address - Phone:410-487-4880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA31428174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist