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General NPI Number Information
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NPI Number | 1235263922
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Entity Type | Individual
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Provider Name | LESLIE MIRIAM LEVINE LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 300 MERCER ST SUITE 22G
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City | NEW YORK
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State | NY
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Zip | 10003-6724
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Country | US
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Telephone | 212-982-6009
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Fax |
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Provider Business Mailing Address
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Address Line | 37 W 12TH ST APT. 4H
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City | NEW YORK
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State | NY
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Zip | 10011-8502
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Country | US
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Telephone | 212-414-1064
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | RO26599-1
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License Number State | NY
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