Provider Demographics
NPI:1194361600
Name:LEVIE, SHOSHANA (LCSW)
Entity Type:Individual
Prefix:
First Name:SHOSHANA
Middle Name:
Last Name:LEVIE
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 1:3692 BEDFORD AVE STE P2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1702
Mailing Address - Country:US
Mailing Address - Phone:646-837-5557
Mailing Address - Fax:646-837-5557
Practice Address - Street 1:222 ROUTE 59 STE 201
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5206
Practice Address - Country:US
Practice Address - Phone:646-847-5557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1254071041C0700X
NJ44SC062112001041C0700X
NY0891271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical