Provider Demographics
NPI:1386678944
Name:LEVA, NEIL IRWIN (MSW)
Entity Type:Individual
Prefix:MR
First Name:NEIL
Middle Name:IRWIN
Last Name:LEVA
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 OCEAN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:TX
Mailing Address - Zip Code:78382-9405
Mailing Address - Country:US
Mailing Address - Phone:361-288-2779
Mailing Address - Fax:361-288-2779
Practice Address - Street 1:100 OCEAN DR
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:TX
Practice Address - Zip Code:78382-9405
Practice Address - Country:US
Practice Address - Phone:361-288-2779
Practice Address - Fax:361-288-2779
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX406091041C0700X
MD73771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LE697346Medicare ID - Type Unspecified