Provider Demographics
NPI:1477619419
Name:REYES LEVINE, CELINA (MSW LCSW R)
Entity Type:Individual
Prefix:MRS
First Name:CELINA
Middle Name:
Last Name:REYES LEVINE
Suffix:
Gender:F
Credentials:MSW LCSW R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 WILD BIRCH FARMS
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-1447
Mailing Address - Country:US
Mailing Address - Phone:914-528-5404
Mailing Address - Fax:
Practice Address - Street 1:50 WILD BIRCH FARMS
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-1447
Practice Address - Country:US
Practice Address - Phone:914-528-1243
Practice Address - Fax:914-528-1243
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR037351 1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
188550OtherMHN
124204OtherVALVE OPTIONS
1008718OtherHIP
NYNC1231Medicare ID - Type Unspecified
1008718OtherHIP