Provider Demographics
NPI:1467264481
Name:LEVIN-EISNER, CHANA BLUMA (MSW)
Entity type:Individual
Prefix:
First Name:CHANA
Middle Name:BLUMA
Last Name:LEVIN-EISNER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 N 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-4228
Mailing Address - Country:US
Mailing Address - Phone:786-245-9179
Mailing Address - Fax:
Practice Address - Street 1:19790 W DIXIE HWY STE 1208
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2548
Practice Address - Country:US
Practice Address - Phone:305-894-6074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW201101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical