Provider Demographics
NPI:1962605329
Name:DENISE P LEVINE LCSW PC
Entity type:Organization
Organization Name:DENISE P LEVINE LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:P
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-375-2778
Mailing Address - Street 1:2340 ROYCE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6616
Mailing Address - Country:US
Mailing Address - Phone:718-375-2778
Mailing Address - Fax:718-376-0512
Practice Address - Street 1:2340 ROYCE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6616
Practice Address - Country:US
Practice Address - Phone:718-375-2778
Practice Address - Fax:718-376-0512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0387991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN46671OtherBLUE CROSS
NY740351OtherGHI
NY2526852OtherOXFORD
NYN46671Medicare ID - Type Unspecified