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NPI Code Detail

MEDICARE: DAHLIA B LEVINE LCSW-C

MEDICARE: DAHLIA B LEVINE LCSW-C
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
11041S0200XSchool Social Worker22493MD

General Provider Information

NPI Number : 1619649605
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAHLIA B LEVINE LCSW-C
Provider Business Mailing Address
First Line : 8169 OLD MONTGOMERY RD
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21043-7940
Country : US
Telephone Number : 443-973-2607
Fax Number :
Provider Business Practice Location Address
First Line : 8169 OLD MONTGOMERY RD
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21043-7940
Country : US
Telephone Number : 443-973-2607
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2021
Last Update Date : 09/29/2021

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Directions to “ DAHLIA B LEVINE LCSW-C” Practice Location

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