Provider Demographics
NPI:1669836144
Name:MELANIE S. LEVINE, PH.D., PLLC
Entity Type:Organization
Organization Name:MELANIE S. LEVINE, PH.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-413-8394
Mailing Address - Street 1:155 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 560
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7799
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:155 N MICHIGAN AVE
Practice Address - Street 2:SUITE 560
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7511
Practice Address - Country:US
Practice Address - Phone:773-413-8394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty