Provider Demographics
NPI:1528768181
Name:LEVINE, BETH ANN (MS ED CRC)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANN
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MS ED CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6655 KILLDEER DR
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9133
Mailing Address - Country:US
Mailing Address - Phone:216-308-5744
Mailing Address - Fax:
Practice Address - Street 1:1815 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1106
Practice Address - Country:US
Practice Address - Phone:216-308-5744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00105074171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator