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NPI Code Detail

MEDICARE: CHLOE LEVINE PSY.D.

MEDICARE:   CHLOE  LEVINE  PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPS1621ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1390200000XOTHERN/A

General Provider Information

NPI Number : 1730647538
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHLOE LEVINE PSY.D.
Provider Business Mailing Address
First Line : 88 BEACON ST
Second Line :
City : PORTLAND
State : ME
Zip : 04103-4022
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19 SOUTH ST
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3963
Country : US
Telephone Number : 207-610-0424
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2019
Last Update Date : 07/15/2020

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Directions to “ CHLOE LEVINE PSY.D.” Practice Location

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