Provider Demographics
NPI:1215396536
Name:LEVIN, HARRY
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:LEVIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 S WARD AVE
Mailing Address - Street 2:
Mailing Address - City:RUMSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07760-2033
Mailing Address - Country:US
Mailing Address - Phone:732-266-1334
Mailing Address - Fax:
Practice Address - Street 1:62 S WARD AVE
Practice Address - Street 2:
Practice Address - City:RUMSON
Practice Address - State:NJ
Practice Address - Zip Code:07760-2033
Practice Address - Country:US
Practice Address - Phone:732-266-1334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00527200101YP2500X
WYLPC-1427101YP2500X
NY006096-1101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional