Provider Demographics
NPI:1427122845
Name:LEVINE, BARBARA A (LICSW)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:A
Last Name:LEVINE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-5527
Mailing Address - Country:US
Mailing Address - Phone:508-655-3202
Mailing Address - Fax:
Practice Address - Street 1:14 VERNON ST
Practice Address - Street 2:SUITE212
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-4733
Practice Address - Country:US
Practice Address - Phone:508-879-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1023561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALE-P21902Medicare ID - Type Unspecified