MEDICARE: LAUREN BETH LEVY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R-051792	NY

General Provider Information

NPI Number	:	1194866228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN BETH LEVY LCSW

Provider Business Mailing Address
First Line	:	245 E 80TH ST APT 6D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-0508
Country	:	US
Telephone Number	:	212-472-5693
Fax Number	:

Provider Business Practice Location Address
First Line	:	157 E 86TH ST STE 2A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-2113
Country	:	US
Telephone Number	:	212-452-3119
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2007
Last Update Date	:	07/08/2007

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