Provider Demographics
NPI:1467881250
Name:LEVINE, EMILY HANNAH (LICSW)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:HANNAH
Last Name:LEVINE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 GREAT PLAIN AVE # 276
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-3031
Mailing Address - Country:US
Mailing Address - Phone:518-527-5407
Mailing Address - Fax:
Practice Address - Street 1:20 MEADOW LANE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492
Practice Address - Country:US
Practice Address - Phone:518-527-5407
Practice Address - Fax:857-347-3098
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1199521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical