MEDICARE: DENISE P LEVINE LCSW PC

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	R038799	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	N46671	OTHER	NY	BLUE CROSS
2	740351	OTHER	NY	GHI
3	2526852	OTHER	NY	OXFORD

General Provider Information

NPI Number	:	1962605329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENISE P LEVINE LCSW PC

Provider Business Mailing Address
First Line	:	2340 ROYCE ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-6616
Country	:	US
Telephone Number	:	718-375-2778
Fax Number	:	718-376-0512

Provider Business Practice Location Address
First Line	:	2340 ROYCE ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-6616
Country	:	US
Telephone Number	:	718-375-2778
Fax Number	:	718-376-0512

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. DENISE P LEVINE
Credential	:	LCSW
Telephone Number	:	718-375-2778

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	08/16/2013

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