Provider Demographics
NPI:1912035957
Name:LEVY, ALLEN LEE (LPA)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:LEE
Last Name:LEVY
Suffix:
Gender:M
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 H STREET
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3450
Mailing Address - Country:US
Mailing Address - Phone:907-222-4954
Mailing Address - Fax:907-222-7862
Practice Address - Street 1:880 H STREET
Practice Address - Street 2:SUITE 204
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3450
Practice Address - Country:US
Practice Address - Phone:907-222-4954
Practice Address - Fax:907-222-7862
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK548101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health