Provider Demographics
NPI:1710941620
Name:LEVY, LUISE K (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LUISE
Middle Name:K
Last Name:LEVY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4813 E LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2750
Mailing Address - Country:US
Mailing Address - Phone:520-325-8063
Mailing Address - Fax:
Practice Address - Street 1:1661 N SWAN RD
Practice Address - Street 2:#102
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4042
Practice Address - Country:US
Practice Address - Phone:520-325-6114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW01731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ70049Medicare UPIN
AZ70049Medicare ID - Type Unspecified