Provider Demographics
NPI:1194195610
Name:LEVIN, MICHELE (LPC, LCADC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:LEVIN
Suffix:
Gender:F
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 W END AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1828
Mailing Address - Country:US
Mailing Address - Phone:908-256-6965
Mailing Address - Fax:
Practice Address - Street 1:73 W END AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1828
Practice Address - Country:US
Practice Address - Phone:908-256-6965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-26
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00210100101YA0400X
NJ37PC00527800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)