Provider Demographics
NPI:1194851238
Name:LEVIN, KAREN B (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:B
Last Name:LEVIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 REED ST
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-3512
Mailing Address - Country:US
Mailing Address - Phone:617-792-5268
Mailing Address - Fax:
Practice Address - Street 1:264 BEACON ST
Practice Address - Street 2:FLOOR 5
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-1236
Practice Address - Country:US
Practice Address - Phone:617-792-5268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7348103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW06320OtherBLUE CROSS BLUE SHIELD MA
MAW51232Medicare ID - Type Unspecified