Provider Demographics
NPI:1003546409
Name:STOLOVE, LEVI MAX (LMSW)
Entity Type:Individual
Prefix:MR
First Name:LEVI
Middle Name:MAX
Last Name:STOLOVE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-1108
Mailing Address - Country:US
Mailing Address - Phone:415-846-6409
Mailing Address - Fax:
Practice Address - Street 1:957 PACIFIC ST APT 304
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-3197
Practice Address - Country:US
Practice Address - Phone:415-846-6409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107137-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical