Provider Demographics
NPI:1912038985
Name:LEVY, JUDITH MILLER (LISW-S, LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:MILLER
Last Name:LEVY
Suffix:
Gender:F
Credentials:LISW-S, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3659 GREEN RD STE 325
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5723
Mailing Address - Country:US
Mailing Address - Phone:323-241-7263
Mailing Address - Fax:
Practice Address - Street 1:3659 GREEN RD STE 325
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5723
Practice Address - Country:US
Practice Address - Phone:323-241-7263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 243741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical