Provider Demographics
NPI:1114542644
Name:LEVINE-KAPKE, NICOLE GABRIELLE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:GABRIELLE
Last Name:LEVINE-KAPKE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:GABRIELLE
Other - Last Name:LEVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:230 E OHIO ST STE 4101232
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3265
Mailing Address - Country:US
Mailing Address - Phone:312-508-3025
Mailing Address - Fax:
Practice Address - Street 1:230 E OHIO ST STE 4101232
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3265
Practice Address - Country:US
Practice Address - Phone:312-508-3025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1173581041C0700X
IL149.0221311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical