Provider Demographics
NPI:1619034014
Name:LEVY, DAVID WILLIAM (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:WILLIAM
Last Name:LEVY
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 S BEMISTON AVE
Mailing Address - Street 2:SUITE 709
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1913
Mailing Address - Country:US
Mailing Address - Phone:314-725-0574
Mailing Address - Fax:
Practice Address - Street 1:130 S BEMISTON AVE
Practice Address - Street 2:SUITE 709
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-1913
Practice Address - Country:US
Practice Address - Phone:314-725-0574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0002781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical