Provider Demographics
NPI:1306025770
Name:LEVY, LYUDMILA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:LYUDMILA
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22110 JAMAICA AVE
Mailing Address - Street 2:RM.210
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428-2037
Mailing Address - Country:US
Mailing Address - Phone:718-740-3310
Mailing Address - Fax:718-740-2605
Practice Address - Street 1:22110 JAMAICA AVE
Practice Address - Street 2:RM 21
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428-2037
Practice Address - Country:US
Practice Address - Phone:718-740-3310
Practice Address - Fax:718-740-2605
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069729283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital