MEDICARE: JACK ANTHNONY LEVY

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	109936	TX

General Provider Information

NPI Number	:	1932031515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACK ANTHNONY LEVY

Provider Business Mailing Address
First Line	:	10032 TRAVIS DR
Second Line	:
City	:	PROVIDENCE VILLAGE
State	:	TX
Zip	:	76227-6011
Country	:	US
Telephone Number	:	940-231-6667
Fax Number	:

Provider Business Practice Location Address
First Line	:	10032 TRAVIS DR
Second Line	:
City	:	PROVIDENCE VILLAGE
State	:	TX
Zip	:	76227-6011
Country	:	US
Telephone Number	:	940-231-6667
Fax Number	:

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

Provider Enumeration Date	:	05/30/2026
Last Update Date	:	05/30/2026

Similar Medicare Providers

1003748062 — WOW THERAPY
Practice Location Address:

10032 TRAVIS DR
PROVIDENCE VILLAGE, TX
76227-6011

Practice Phone: 214-267-9021
Practice Fax:

1255263984 — ALLISON LEVY LCSW
Practice Location Address:

10032 TRAVIS DR
PROVIDENCE VILLAGE, TX
76227-6011

Practice Phone: 214-267-9021
Practice Fax:

1558591776 — MRS. VITA M D'ANGELO SLP
Practice Location Address:

6011 74TH ST
MIDDLE VILLAGE, NY
11379-5217

Practice Phone: 516-805-2925
Practice Fax:

1578942710 — MRS. RAFFAELA MCKENNA
Practice Location Address:

6011 76TH ST
MIDDLE VILLAGE, NY
11379-5227

Practice Phone: 646-596-6211
Practice Fax:

1023136744 — MRS. SARAH ALYSE DETRICK LMFT
Practice Location Address:

9001 HUXLEY DR
PROVIDENCE VILLAGE, TX
76227-2180

Practice Phone: 661-444-1108
Practice Fax:

1891982161 — JENNIFER MEYER M.A.CCC-SLP
Practice Location Address:

1105 LIVE OAK DR
PROVIDENCE VILLAGE, TX
76227-5491

Practice Phone: 214-538-7328
Practice Fax:

Directions to “ JACK ANTHNONY LEVY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.