Provider Demographics
NPI:1619649605
Name:LEVINE, DAHLIA B (LCSW-C)
Entity Type:Individual
Prefix:
First Name:DAHLIA
Middle Name:B
Last Name:LEVINE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8169 OLD MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-7940
Mailing Address - Country:US
Mailing Address - Phone:443-973-2607
Mailing Address - Fax:
Practice Address - Street 1:8169 OLD MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-7940
Practice Address - Country:US
Practice Address - Phone:443-973-2607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD224931041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool