Healthcare Provider Details

I. General information

NPI: 1134045578
Provider Name (Legal Business Name): SAMANTHA ROSE LEVINSON
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW APT 418
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

1884 COLUMBIA RD NW APT 418
WASHINGTON DC
20009-5146
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-5592
  • Fax:
Mailing address:
  • Phone: 704-956-6595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP200001874
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: