Healthcare Provider Details

I. General information

NPI: 1316901614
Provider Name (Legal Business Name): GREGORY P. LEVINE L.P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 PRIMROSE LN
MOUNT ARLINGTON NJ
07856-1332
US

IV. Provider business mailing address

12 PRIMROSE LN
MOUNT ARLINGTON NJ
07856-1332
US

V. Phone/Fax

Practice location:
  • Phone: 973-342-7572
  • Fax:
Mailing address:
  • Phone: 973-342-7572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00334300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: