Provider Demographics
NPI:1902044233
Name:LEVY, BARRY TONNIS (MFT)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:TONNIS
Last Name:LEVY
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 N BELLFLOWER BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1132
Mailing Address - Country:US
Mailing Address - Phone:562-673-1417
Mailing Address - Fax:562-420-9988
Practice Address - Street 1:1945 PALO VERDE AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-3443
Practice Address - Country:US
Practice Address - Phone:562-673-1417
Practice Address - Fax:562-799-3355
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 13388106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist