Healthcare Provider Details

I. General information

NPI: 1063773802
Provider Name (Legal Business Name): LEVIN JAERED SIBLEY-SCHWARTZ LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2012
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 NUMBER 6 RD
LEVERETT MA
01054-9705
US

IV. Provider business mailing address

17 NUMBER 6 RD
LEVERETT MA
01054-9705
US

V. Phone/Fax

Practice location:
  • Phone: 413-834-4528
  • Fax: 971-406-4864
Mailing address:
  • Phone: 413-834-4528
  • Fax: 971-406-4864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number217820
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: