Provider Demographics
NPI:1861552663
Name:LEVINE, BETSY (LCSW)
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:
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 1:303 FIFTH AVE
Mailing Address - Street 2:SUITE 606
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6601
Mailing Address - Country:US
Mailing Address - Phone:212-647-8751
Mailing Address - Fax:
Practice Address - Street 1:303 FIFTH AVE
Practice Address - Street 2:SUITE 606
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6601
Practice Address - Country:US
Practice Address - Phone:212-647-8751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR04288611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY238946OtherMHN ID
NYP3673663OtherOXFORD ID
NYP472470OtherOXFORD ID
NY238946OtherMHN ID
NYP3673663OtherOXFORD ID