Provider Demographics
NPI:1619300068
Name:LEVY, REBECCA (LBA, BCBA, MSED)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:LBA, BCBA, MSED
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:LEVY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LBA, BCBA, MSED
Mailing Address - Street 1:7547 181ST ST
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1609
Mailing Address - Country:US
Mailing Address - Phone:718-969-3489
Mailing Address - Fax:
Practice Address - Street 1:7547 181ST ST
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1609
Practice Address - Country:US
Practice Address - Phone:718-503-2502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY403571174H00000X
NY002244103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174H00000XOther Service ProvidersHealth Educator