Provider Demographics
NPI:1396133534
Name:LEVINE, DAVID HARVEY (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:HARVEY
Last Name:LEVINE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4699 N FEDERAL HWY
Mailing Address - Street 2:# 102F
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6510
Mailing Address - Country:US
Mailing Address - Phone:561-716-3009
Mailing Address - Fax:
Practice Address - Street 1:4800 N FEDERAL HWY
Practice Address - Street 2:SUITE 203A
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5188
Practice Address - Country:US
Practice Address - Phone:561-716-3009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-22
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 123701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical