MEDICARE: BRITTANY K LEVY LCPC

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	101Y00000X	Counselor	180.008955	IL
2	101YM0800X	Mental Health Counselor	180.008955	IL
3	101YP2500X	Professional Counselor	180.008955	IL

General Provider Information

NPI Number	:	1548642119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY K LEVY LCPC

Provider Business Mailing Address
First Line	:	4526 N. RAVENSWOOD AVE
Second Line	:	SUITE 313
City	:	CHICAGO
State	:	IL
Zip	:	60613-2419
Country	:	US
Telephone Number	:	312-725-2014
Fax Number	:

Provider Business Practice Location Address
First Line	:	4526 N. RAVENSWOOD AVE
Second Line	:	SUITE 313
City	:	CHICAGO
State	:	IL
Zip	:	60613-2419
Country	:	US
Telephone Number	:	312-725-2014
Fax Number	:

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

Provider Enumeration Date	:	06/19/2015
Last Update Date	:	01/30/2017

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