Provider Demographics
NPI:1558585471
Name:LEVINSON, DORTHY M (MSW)
Entity Type:Individual
Prefix:MS
First Name:DORTHY
Middle Name:M
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 WEST 87TH STREET
Mailing Address - Street 2:11B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2847
Mailing Address - Country:US
Mailing Address - Phone:212-874-6019
Mailing Address - Fax:
Practice Address - Street 1:247 WEST 87TH STREET
Practice Address - Street 2:11B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2847
Practice Address - Country:US
Practice Address - Phone:212-874-6019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR01355911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N3187OtherBLUE CROSS BLUE SHIELD