Provider Demographics
NPI:1750831640
Name:LEVENSON, RACHEL B (PHD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:B
Last Name:LEVENSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 RIVERSIDE DR
Mailing Address - Street 2:# 14C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1007
Mailing Address - Country:US
Mailing Address - Phone:201-755-1393
Mailing Address - Fax:
Practice Address - Street 1:345 7TH AVE STE 1201H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5006
Practice Address - Country:US
Practice Address - Phone:201-755-1393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-04
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021857103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical