Healthcare Provider Details

I. General information

NPI: 1417329434
Provider Name (Legal Business Name): MARNIE LEVENSON LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2015
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 RENATO CT STE 6
REDWOOD CITY CA
94061-4016
US

IV. Provider business mailing address

524 SUNSET WAY
EMERALD HILLS CA
94062-4028
US

V. Phone/Fax

Practice location:
  • Phone: 650-241-9914
  • Fax:
Mailing address:
  • Phone: 701-541-5229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC8675
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: