Provider Demographics
NPI:1346437167
Name:LEVY, PAMELA SUZANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:SUZANNE
Last Name:LEVY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:SUZANNE
Other - Last Name:HASKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1801 BUSH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5296
Mailing Address - Country:US
Mailing Address - Phone:415-823-5432
Mailing Address - Fax:
Practice Address - Street 1:1801 BUSH ST STE 201
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5296
Practice Address - Country:US
Practice Address - Phone:415-823-5432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA258391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical