MEDICARE: NATALIE LEVIN AND ASSOCIATES, LLC

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	103TC0700X	Clinical Psychologist	LP3733	MN

General Provider Information

NPI Number	:	1942545322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATALIE LEVIN AND ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	2915 WAYZATA BLVD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2145
Country	:	US
Telephone Number	:	952-746-3221
Fax Number	:	612-341-9079

Provider Business Practice Location Address
First Line	:	2915 WAYZATA BLVD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2145
Country	:	US
Telephone Number	:	952-746-3221
Fax Number	:	612-341-9079

Authorized Official
Title or Position	:	OWNER
Name	:	MS. NATALIE LEVIN
Credential	:	MA LP
Telephone Number	:	952-746-3221

Provider Enumeration Date	:	12/11/2012
Last Update Date	:	12/11/2012

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