Provider Demographics
NPI:1073945200
Name:LEVIN, BROOKE (MS, LCGC)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:MISS
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:LEVENSELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LCGC
Mailing Address - Street 1:1 FEDERAL ST STE SW200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:2 COOPER PLZ 400 HADDON AVENUE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:855-632-2667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS