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General NPI Number Information
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NPI Number | 1457362220
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Entity Type | Individual
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Provider Name | BETH LEVINE LCSW,JD
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Gender | Female
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 07/29/2011
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Provider Practice Location Address
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Address Line | 3545 LAKE AVE SUITE 200
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City | WILMETTE
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State | IL
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Zip | 60091-1058
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Country | US
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Telephone | 847-251-7350
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Fax | 847-853-2600
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Provider Business Mailing Address
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Address Line | 428 ELDER LN
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City | WINNETKA
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State | IL
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Zip | 60093-4251
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Country | US
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Telephone | 847-446-6778
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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 | 150008176
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License Number State | IL
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