Healthcare Provider Details

I. General information

NPI: 1346450467
Provider Name (Legal Business Name): REVA LEVINE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 N HIGHWAY A1A STE A104
JUPITER FL
33477-4561
US

IV. Provider business mailing address

725 N HIGHWAY A1A STE A104
JUPITER FL
33477-4561
US

V. Phone/Fax

Practice location:
  • Phone: 561-516-0806
  • Fax:
Mailing address:
  • Phone: 561-516-0806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW7923
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: