Provider Demographics
NPI:1073926267
Name:LEVITSKY, LEONID (LSW)
Entity Type:Individual
Prefix:
First Name:LEONID
Middle Name:
Last Name:LEVITSKY
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BERGEN ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2908
Mailing Address - Country:US
Mailing Address - Phone:201-336-4244
Mailing Address - Fax:
Practice Address - Street 1:46 BERGEN ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2908
Practice Address - Country:US
Practice Address - Phone:201-336-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2018-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05946800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker