Provider Demographics
NPI:1821175704
Name:LEVIN, VIVIAN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4888 LOOP CENTRAL DR
Mailing Address - Street 2:SUITE 510
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-2214
Mailing Address - Country:US
Mailing Address - Phone:713-346-1551
Mailing Address - Fax:713-346-1577
Practice Address - Street 1:4888 LOOP CENTRAL DR
Practice Address - Street 2:SUITE 510
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-2214
Practice Address - Country:US
Practice Address - Phone:713-346-1551
Practice Address - Fax:713-346-1577
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11104104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00225PMedicare ID - Type Unspecified