Provider Demographics
NPI:1154641900
Name:LEVINE-ADLER P.A.
Entity Type:Organization
Organization Name:LEVINE-ADLER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:LEVINE
Authorized Official - Last Name:ADLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:952-707-1820
Mailing Address - Street 1:200 E TRAVELERS TRL
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4097
Mailing Address - Country:US
Mailing Address - Phone:952-707-1820
Mailing Address - Fax:
Practice Address - Street 1:200 E TRAVELERS TRL
Practice Address - Street 2:SUITE 225
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4097
Practice Address - Country:US
Practice Address - Phone:952-707-1820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2202103T00000X, 103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty