Healthcare Provider Details

I. General information

NPI: 1114049236
Provider Name (Legal Business Name): RACHEL DEENA LEVENSON MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 CAMBRIDGE ST
CAMBRIDGE MA
02141-1001
US

IV. Provider business mailing address

96 CEDAR ST # A
SOMERVILLE MA
02143-1321
US

V. Phone/Fax

Practice location:
  • Phone: 617-441-1800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: