Provider Demographics
NPI:1427113752
Name:LEVITT, CAROLE PESTRONK (LCSW)
Entity type:Individual
Prefix:MS
First Name:CAROLE
Middle Name:PESTRONK
Last Name:LEVITT
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 1:3 PHEASANT RUN
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-3423
Mailing Address - Country:US
Mailing Address - Phone:914-633-1689
Mailing Address - Fax:914-235-4215
Practice Address - Street 1:3 PHEASANT RUN
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-3423
Practice Address - Country:US
Practice Address - Phone:914-633-1689
Practice Address - Fax:914-235-4215
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03500011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA300000517Medicare PIN