Provider Demographics
NPI:1003966987
Name:LEVIN, MARIA GRAZIA NARDELLI (LCSW, LPP)
Entity Type:Individual
Prefix:
First Name:MARIA GRAZIA
Middle Name:NARDELLI
Last Name:LEVIN
Suffix:
Gender:F
Credentials:LCSW, LPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420A W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-1836
Mailing Address - Country:US
Mailing Address - Phone:859-965-9474
Mailing Address - Fax:859-439-0611
Practice Address - Street 1:420 A WEST WALNUT
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1235
Practice Address - Country:US
Practice Address - Phone:859-965-9474
Practice Address - Fax:859-439-0611
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY11561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30615058Medicaid
KY30615058Medicaid
KY0454Medicare ID - Type UnspecifiedMEDICARE