Provider Demographics
NPI:1184867046
Name:LEVINSON, SAMANTHA LAUREN (SAMANTHA LEVINSON MA)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:LAUREN
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:SAMANTHA LEVINSON MA
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:LEVINSON MA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:604 HAGNER ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-1406
Mailing Address - Country:US
Mailing Address - Phone:908-839-2953
Mailing Address - Fax:
Practice Address - Street 1:604 HAGNER ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1406
Practice Address - Country:US
Practice Address - Phone:908-839-2953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health