MEDICARE: MR. RICHARD BURTON LEVINSON 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	008219	TX

General Provider Information

NPI Number	:	1205120607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD BURTON LEVINSON LCSW

Provider Business Mailing Address
First Line	:	3839 BEE CAVE RD STE 202
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-5318
Country	:	US
Telephone Number	:	512-328-5577
Fax Number	:

Provider Business Practice Location Address
First Line	:	3839 BEE CAVE RD STE 202
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-5318
Country	:	US
Telephone Number	:	512-328-5577
Fax Number	:

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

Provider Enumeration Date	:	06/02/2011
Last Update Date	:	06/02/2011

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