Provider Demographics
NPI:1134511967
Name:LEVINSON, COLLEEN (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 WARREN CARROLL DR
Mailing Address - Street 2:BOX 8502
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27695-0001
Mailing Address - Country:US
Mailing Address - Phone:919-515-2111
Mailing Address - Fax:
Practice Address - Street 1:2500 WARREN CARROLL DR
Practice Address - Street 2:BOX 8502
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27695-0001
Practice Address - Country:US
Practice Address - Phone:919-515-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-24802255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCLAT-2480OtherNORTH CAROLINA BOARD OF ATHLETIC TRAINING EXAMINERS
2000016011OtherBOARD OF CERTIFICATION