Provider Demographics
NPI:1417329434
Name:LEVENSON, MARNIE (LMHC)
Entity Type:Individual
Prefix:
First Name:MARNIE
Middle Name:
Last Name:LEVENSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 BELMONT AVE E
Mailing Address - Street 2:APT. #2
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-4481
Mailing Address - Country:US
Mailing Address - Phone:701-541-5229
Mailing Address - Fax:
Practice Address - Street 1:1100 VIRGINIA ST
Practice Address - Street 2:STE 210
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1439
Practice Address - Country:US
Practice Address - Phone:206-470-3856
Practice Address - Fax:206-470-3857
Is Sole Proprietor?:No
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60555104101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health