Provider Demographics
NPI:1144450008
Name:LEVENKRON, RACHEL PHOEBE (LCSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:PHOEBE
Last Name:LEVENKRON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:PHOEBE
Other - Last Name:ACTIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:258 HAWLEY RD
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10560-2602
Mailing Address - Country:US
Mailing Address - Phone:914-485-1050
Mailing Address - Fax:
Practice Address - Street 1:153 E MAIN ST
Practice Address - Street 2:SUITE F2
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2317
Practice Address - Country:US
Practice Address - Phone:914-482-5335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP0568991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical