Provider Demographics
NPI:1568691749
Name:DR LEVINSTEIN THERAPY GROUP INC
Entity Type:Organization
Organization Name:DR LEVINSTEIN THERAPY GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRES. CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:P
Authorized Official - Last Name:LEVINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DHD, MSW, LCSW
Authorized Official - Phone:201-652-9789
Mailing Address - Street 1:65 N. MAPLE AVE
Mailing Address - Street 2:SUITE #212
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450
Mailing Address - Country:US
Mailing Address - Phone:201-652-9789
Mailing Address - Fax:
Practice Address - Street 1:65 N. MAPLE AVE
Practice Address - Street 2:SUITE #212
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450
Practice Address - Country:US
Practice Address - Phone:201-652-9789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJLCSWNJ445C00433200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty