Healthcare Provider Details

I. General information

NPI: 1124425913
Provider Name (Legal Business Name): JAMES LEVINE & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2014
Last Update Date: 11/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 COLLEGE ST SUITE 6
SOUTH HADLEY MA
01075-1148
US

IV. Provider business mailing address

9 COLLEGE ST SUITE 6
SOUTH HADLEY MA
01075-1148
US

V. Phone/Fax

Practice location:
  • Phone: 413-534-7400
  • Fax: 413-534-7483
Mailing address:
  • Phone: 413-534-7400
  • Fax: 413-534-7483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7295
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number116810
License Number StateMA

VIII. Authorized Official

Name: MARISA A PASTERCZYK
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 413-534-7400