Provider Demographics
NPI:1134115496
Name:LEVINSKY, LOIS (LICSW)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:
Last Name:LEVINSKY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 EASTMAN RD
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-1306
Mailing Address - Country:US
Mailing Address - Phone:617-666-2039
Mailing Address - Fax:617-666-6773
Practice Address - Street 1:8 EASTMAN RD
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-1306
Practice Address - Country:US
Practice Address - Phone:617-666-2039
Practice Address - Fax:617-666-6773
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW 1023591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALE P01083OtherBCBSMA
MALE P21866Medicare ID - Type UnspecifiedMEDICARE B