Provider Demographics
NPI:1497748099
Name:LEVINSON, SHELDON L (PHD)
Entity type:Individual
Prefix:
First Name:SHELDON
Middle Name:L
Last Name:LEVINSON
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10509 TIMBERWOOD CIR STE 250
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5301
Mailing Address - Country:US
Mailing Address - Phone:502-423-1151
Mailing Address - Fax:
Practice Address - Street 1:10509 TIMBERWOOD CIR STE 250
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5301
Practice Address - Country:US
Practice Address - Phone:502-423-1151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY128113103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8900026900Medicaid
KY8900026900Medicaid
KYS48123Medicare UPIN