Provider Demographics
NPI:1821186131
Name:LEVIN, SHARI P (LCSW, QCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:P
Last Name:LEVIN
Suffix:
Gender:F
Credentials:LCSW, QCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2924 HOYT AVE S
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-1738
Mailing Address - Country:US
Mailing Address - Phone:718-721-0633
Mailing Address - Fax:718-721-0699
Practice Address - Street 1:2924 HOYT AVE S
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-1738
Practice Address - Country:US
Practice Address - Phone:718-721-0606
Practice Address - Fax:718-721-4494
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR046909-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN6R87OtherEMPIRE/MAGELLAN
NYP2705742OtherOXFORD
NY02284751Medicaid
NYN6R87OtherEMPIRE/MAGELLAN