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General NPI Number Information
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NPI Number | 1376251967
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Entity Type | Organization
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Legal Business Name | LEVINE BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 11/11/2022
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 1 E ERIE ST STE 525-3022
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City | CHICAGO
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State | IL
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Zip | 60611-2740
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Country | US
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Telephone | 310-428-0232
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Fax | 310-388-4678
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Provider Business Mailing Address
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Address Line | 15515 W SUNSET BLVD UNIT 117
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-3530
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Country | US
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Telephone | 310-428-0232
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Fax | 310-388-4678
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Authorized Official
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Title or Position | OWNER, FOUNDER, MANAGER
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Name | JENNY LEVINE
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Credential | LCPC
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Telephone | 310-428-0232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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