Provider Demographics
NPI:1225126402
Name:LEVENSON, JOYCE ELLEN (LICSW)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:ELLEN
Last Name:LEVENSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 COMMONWEALTH AVENUE
Mailing Address - Street 2:STE 202 CATHOLIC CHARITIES
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923
Mailing Address - Country:US
Mailing Address - Phone:978-774-6820
Mailing Address - Fax:978-777-4242
Practice Address - Street 1:140 COMMONWEALTH AVENUE
Practice Address - Street 2:CATHOLIC CHARITIES
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923
Practice Address - Country:US
Practice Address - Phone:978-774-6820
Practice Address - Fax:978-777-4242
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1046931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P02852Medicare ID - Type Unspecified