Provider Demographics
NPI:1003068842
Name:LEVINE, PAUL HOWARD (LCSW)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:HOWARD
Last Name:LEVINE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29300 THE OLD RD
Mailing Address - Street 2:JMET - BOQ 2
Mailing Address - City:CASTAIC
Mailing Address - State:CA
Mailing Address - Zip Code:91384-2905
Mailing Address - Country:US
Mailing Address - Phone:661-294-6331
Mailing Address - Fax:
Practice Address - Street 1:29300 THE OLD RD
Practice Address - Street 2:JMET - BOQ 2
Practice Address - City:CASTAIC
Practice Address - State:CA
Practice Address - Zip Code:91384-2905
Practice Address - Country:US
Practice Address - Phone:661-294-6331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS183301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical