Provider Demographics
NPI:1952657207
Name:STONE-LEVINE, JENNIFER (LMSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:STONE-LEVINE
Suffix:
Gender:F
Credentials:LMSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 E 30TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8321
Mailing Address - Country:US
Mailing Address - Phone:646-283-1060
Mailing Address - Fax:
Practice Address - Street 1:1841 BROADWAY
Practice Address - Street 2:INSTITUTE FOR CONTEMPORARY PSYCHOTHERAPY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7603
Practice Address - Country:US
Practice Address - Phone:212-333-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054621-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker