Provider Demographics
NPI:1336269448
Name:LEVIN, PAMELA ELAYNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:ELAYNE
Last Name:LEVIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 W DEMPSTER STREET
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077
Mailing Address - Country:US
Mailing Address - Phone:847-965-1260
Mailing Address - Fax:847-792-0210
Practice Address - Street 1:5301 W DEMPSTER STREET
Practice Address - Street 2:SUITE 304
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077
Practice Address - Country:US
Practice Address - Phone:847-965-1260
Practice Address - Fax:847-792-0210
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490109361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical