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General NPI Number Information
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NPI Number | 1568691749
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Entity Type | Organization
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Legal Business Name | DR LEVINSTEIN THERAPY GROUP INC
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 07/08/2009
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Provider Practice Location Address
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Address Line | 65 N. MAPLE AVE SUITE #212
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City | RIDGEWOOD
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State | NJ
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Zip | 07450
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Country | US
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Telephone | 201-652-9789
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Fax |
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Provider Business Mailing Address
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Address Line | 65 N. MAPLE AVE SUITE #212
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City | RIDGEWOOD
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State | NJ
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Zip | 07450
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Country | US
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Telephone | 201-652-9789
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Fax |
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Authorized Official
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Title or Position | OWNER / PRES. CORPORATION
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Name | DR. KELLY P. LEVINSTEIN
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Credential | DHD, MSW, LCSW
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Telephone | 201-652-9789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LCSWNJ445C00433200
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License Number State | NJ
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