Provider Demographics
NPI:1144338906
Name:LEVINE, ROBERT ANDREW (LCSW)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ANDREW
Last Name:LEVINE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5824 BEE RIDGE RD
Mailing Address - Street 2:PMB 307
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-5065
Mailing Address - Country:US
Mailing Address - Phone:941-921-0527
Mailing Address - Fax:941-929-7869
Practice Address - Street 1:2426 BEE RIDGE RD
Practice Address - Street 2:#B
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-6350
Practice Address - Country:US
Practice Address - Phone:941-921-0527
Practice Address - Fax:941-929-7869
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW31711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ5547Medicare PIN