Provider Demographics
NPI:1164642468
Name:LEVINTHAL, SHELLY ROBIN (LCSW)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:ROBIN
Last Name:LEVINTHAL
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 1:6320 SWAINLAND RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-1844
Mailing Address - Country:US
Mailing Address - Phone:510-655-9165
Mailing Address - Fax:
Practice Address - Street 1:235 WEST MACARTHUR BLVD. MB BLDG, SUITE 630
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611
Practice Address - Country:US
Practice Address - Phone:510-752-6015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 94901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical