Provider Demographics
NPI:1003694183
Name:LEVANGIE, ENID ANGELINA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ENID
Middle Name:ANGELINA
Last Name:LEVANGIE
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 1:288 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02460-1948
Mailing Address - Country:US
Mailing Address - Phone:617-935-2569
Mailing Address - Fax:
Practice Address - Street 1:288 WALNUT ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02460-1948
Practice Address - Country:US
Practice Address - Phone:617-935-2569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2296331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical