Provider Demographics
NPI:1407925514
Name:LEVY, BARRY (LCSW)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 N WASHINGTON ST
Mailing Address - Street 2:206
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1715
Mailing Address - Country:US
Mailing Address - Phone:301-315-9009
Mailing Address - Fax:301-315-2288
Practice Address - Street 1:230 N WASHINGTON ST
Practice Address - Street 2:206
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1715
Practice Address - Country:US
Practice Address - Phone:301-315-9009
Practice Address - Fax:301-315-2288
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD061691041C0700X
VA09040019841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD694004Medicare PIN