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General NPI Number Information
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NPI Number | 1083964860
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Entity Type | Individual
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Provider Name | JAMIE LEVIN LCPC
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Gender | Female
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Dates
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Enumeration Date | 09/19/2012
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 24998 SW BIG FIR RD
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City | WEST LINN
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State | OR
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Zip | 97068-8607
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Country | US
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Telephone | 503-825-8822
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Fax |
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Provider Business Mailing Address
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Address Line | 24998 SW BIG FIR RD
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City | WEST LINN
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State | OR
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Zip | 97068-8607
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Country | US
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Telephone | 503-825-8822
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178008445
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License Number State | IL
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