Healthcare Provider Details

I. General information

NPI: 1003793415
Provider Name (Legal Business Name): LEVINE HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7832 PENCE POND LN
CHARLOTTE NC
28227-2449
US

IV. Provider business mailing address

7900D STEVENS MILL RD STE 132
MATTHEWS NC
28104-2929
US

V. Phone/Fax

Practice location:
  • Phone: 704-441-0860
  • Fax:
Mailing address:
  • Phone: 704-441-0860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIAN GEOFFREY HARRIS
Title or Position: PRESIDENT
Credential: PHD
Phone: 704-441-0860