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General NPI Number Information
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NPI Number | 1093871519
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Entity Type | Individual
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Provider Name | MARK LEVINE LCSW
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Gender | Male
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 487 S BROADWAY
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City | YONKERS
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State | NY
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Zip | 10705-3269
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Country | US
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Telephone | 914-423-4433
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Fax | 914-423-9434
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Provider Business Mailing Address
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Address Line | 119 NORTHMORE DR
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City | YORKTOWN HEIGHTS
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State | NY
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Zip | 10598-4316
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Country | US
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Telephone | 914-423-4433
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Fax | 914-423-9434
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R019547
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License Number State | NY
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