Provider Demographics
NPI:1982227021
Name:LEVINSTEIN, ADEE (MS, RD, LD, CEDS-S)
Entity Type:Individual
Prefix:MS
First Name:ADEE
Middle Name:
Last Name:LEVINSTEIN
Suffix:
Gender:F
Credentials:MS, RD, LD, CEDS-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11328 CHURCH CANYON DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-5900
Mailing Address - Country:US
Mailing Address - Phone:636-675-3358
Mailing Address - Fax:
Practice Address - Street 1:1809 DENTON RIDGE CT
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-8793
Practice Address - Country:US
Practice Address - Phone:636-675-3358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-23
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020010551133V00000X
TXDT85147133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered