Healthcare Provider Details

I. General information

NPI: 1184531253
Provider Name (Legal Business Name): RICHARD JOEL LEVITT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 BROADWAY # 1007
NEW YORK NY
10010-3450
US

IV. Provider business mailing address

222 E 80TH ST APT 3A
NEW YORK NY
10075-0560
US

V. Phone/Fax

Practice location:
  • Phone: 646-531-6377
  • Fax:
Mailing address:
  • Phone: 646-531-6377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number001301
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: