Provider Demographics
NPI:1982449815
Name:LEVY, CARLA ANN
Entity type:Individual
Prefix:MS
First Name:CARLA
Middle Name:ANN
Last Name:LEVY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 E 93RD ST APT 17A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5553
Mailing Address - Country:US
Mailing Address - Phone:917-355-7209
Mailing Address - Fax:
Practice Address - Street 1:340 E 93RD ST APT 17A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-5553
Practice Address - Country:US
Practice Address - Phone:917-355-7209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001212102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst