Provider Demographics
NPI:1326457706
Name:MARK LEVINSKY LMHC LLC
Entity Type:Organization
Organization Name:MARK LEVINSKY LMHC LLC
Other - Org Name:INTENTIONAL LIVING COACHING & COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:561-368-9940
Mailing Address - Street 1:7301 W PALMETTO PARK RD STE 104B
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3455
Mailing Address - Country:US
Mailing Address - Phone:561-368-9940
Mailing Address - Fax:
Practice Address - Street 1:7301 W PALMETTO PARK RD STE 104B
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3455
Practice Address - Country:US
Practice Address - Phone:561-368-9940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6755251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health