MEDICARE: BRENT LEWIN LEVINSON PH.D.

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	103T00000X	Psychologist	174	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	174	OTHER	MA	PSYCHOLOGY LICENSE
2	W01456	OTHER	MA	BLUE CROSS BLUE SHIELD
3	4456188	OTHER	MA	AETNA

General Provider Information

NPI Number	:	1861428484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENT LEWIN LEVINSON PH.D.

Provider Business Mailing Address
First Line	:	147 CYPRESS ST
Second Line	:
City	:	NEWTON CENTER
State	:	MA
Zip	:	02459-2225
Country	:	US
Telephone Number	:	617-964-7654
Fax Number	:	617-964-7654

Provider Business Practice Location Address
First Line	:	147 CYPRESS ST
Second Line	:
City	:	NEWTON CENTER
State	:	MA
Zip	:	02459-2225
Country	:	US
Telephone Number	:	617-964-7654
Fax Number	:	617-964-7654

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

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	12/14/2025

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Directions to “ BRENT LEWIN LEVINSON PH.D.” Practice Location

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