Provider Demographics
NPI:1629016886
Name:A & P LEVINE PSYCHOTHERAPY, INC.
Entity Type:Organization
Organization Name:A & P LEVINE PSYCHOTHERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:RF
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:303-678-7455
Mailing Address - Street 1:709 KIMBARK ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-4968
Mailing Address - Country:US
Mailing Address - Phone:303-678-7455
Mailing Address - Fax:303-772-3887
Practice Address - Street 1:709 KIMBARK ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501
Practice Address - Country:US
Practice Address - Phone:303-678-7455
Practice Address - Fax:303-772-3887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO16607376Medicaid
CO16607376Medicaid