Provider Demographics
NPI:1013662287
Name:LEVINE, ADAM (LSW)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:LEVINE
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLE SHADE
Mailing Address - State:NJ
Mailing Address - Zip Code:08052-2253
Mailing Address - Country:US
Mailing Address - Phone:301-787-3870
Mailing Address - Fax:
Practice Address - Street 1:501 CAMBRIA AVE
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-7213
Practice Address - Country:US
Practice Address - Phone:215-650-7790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA136995104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker