Provider Demographics
NPI:1083750095
Name:LEVINE, LOIS JAFFIN (LCSW)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:JAFFIN
Last Name:LEVINE
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 1:101 CLARK ST
Mailing Address - Street 2:DUPLEX 2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2746
Mailing Address - Country:US
Mailing Address - Phone:718-855-9185
Mailing Address - Fax:718-624-2985
Practice Address - Street 1:187 HICKS ST
Practice Address - Street 2:APT. B.
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-2373
Practice Address - Country:US
Practice Address - Phone:718-855-9185
Practice Address - Fax:718-624-2985
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR 013558-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical