Provider Demographics
NPI:1831239318
Name:LEVICK, MARLENE S (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:S
Last Name:LEVICK
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 1:1700 PATRICIA AVE
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-3511
Mailing Address - Country:US
Mailing Address - Phone:727-812-4122
Mailing Address - Fax:
Practice Address - Street 1:3060 ALT 19
Practice Address - Street 2:SUITE B-9
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-1929
Practice Address - Country:US
Practice Address - Phone:727-348-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW80831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical