=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508916479
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN S LEVY L.P.C.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/11/2007
-----------------------------------------------------
Last Update Date | 05/07/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 308 BARNES RD
-----------------------------------------------------
City | WILLIAMSTOWN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41097-9483
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-824-4442
-----------------------------------------------------
Fax | 859-824-4448
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 503 FARRELL DRIVE P.O. BOX 2680
-----------------------------------------------------
City | COVINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41012-2680
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-578-3228
-----------------------------------------------------
Fax | 859-578-3270
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 283
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------