Provider Demographics
NPI:1689913386
Name:LEVIN, AMY B (MHC,CASAC)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:B
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MHC,CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-3213
Mailing Address - Country:US
Mailing Address - Phone:917-817-2820
Mailing Address - Fax:
Practice Address - Street 1:19 N BROADWAY
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-3213
Practice Address - Country:US
Practice Address - Phone:917-817-2820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25008101YA0400X
NY005137-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)