Healthcare Provider Details

I. General information

NPI: 1255108122
Provider Name (Legal Business Name): CHLOE LEVIN LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2023
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 WELLER RD
SILVER SPRING MD
20906-4156
US

IV. Provider business mailing address

8010 BLAIR MILL WAY APT 602E
SILVER SPRING MD
20910-6863
US

V. Phone/Fax

Practice location:
  • Phone: 240-869-6349
  • Fax:
Mailing address:
  • Phone: 860-428-9849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number27464
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: