Provider Demographics
NPI:1326103482
Name:LEVITAN, JUDITH GAIL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:GAIL
Last Name:LEVITAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:185 E 85TH ST
Mailing Address - Street 2:SUITE 29J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2140
Mailing Address - Country:US
Mailing Address - Phone:212-722-7921
Mailing Address - Fax:212-722-5121
Practice Address - Street 1:185 E 85TH ST
Practice Address - Street 2:SUITE 29J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2140
Practice Address - Country:US
Practice Address - Phone:212-722-7921
Practice Address - Fax:212-722-5121
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR012438-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical