Provider Demographics
NPI:1144464645
Name:LEVINE, FLORENCE ANNETTE (LCSW)
Entity type:Individual
Prefix:MS
First Name:FLORENCE
Middle Name:ANNETTE
Last Name:LEVINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 MINEOLA BLVD APT 4P
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2534
Mailing Address - Country:US
Mailing Address - Phone:516-747-4218
Mailing Address - Fax:
Practice Address - Street 1:190 MINEOLA BLVD APT 4P
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2534
Practice Address - Country:US
Practice Address - Phone:516-747-4218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-28
Last Update Date:2016-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO56338-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA300134815Medicare PIN