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General NPI Number Information
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NPI Number | 1013460013
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Entity Type | Individual
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Provider Name | KATHLEEN LEVENSON
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Gender | Female
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Dates
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Enumeration Date | 07/26/2016
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 248 HIGBIE LN FL 1
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City | WEST ISLIP
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State | NY
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Zip | 11795-2828
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Country | US
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Telephone | 631-867-2501
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Fax |
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Provider Business Mailing Address
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Address Line | 85 PHILADELPHIA AVE
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City | MASSAPEQUA PARK
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State | NY
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Zip | 11762-2547
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Country | US
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Telephone | 631-383-1872
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | P133207
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License Number State | NY
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