Provider Demographics
NPI:1104170133
Name:LEVINE, HAL WILLIAM (LMFT, LPCC)
Entity type:Individual
Prefix:MR
First Name:HAL
Middle Name:WILLIAM
Last Name:LEVINE
Suffix:
Gender:M
Credentials:LMFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21062
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-9062
Mailing Address - Country:US
Mailing Address - Phone:510-415-9114
Mailing Address - Fax:510-550-7997
Practice Address - Street 1:24100 AMADOR ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-1273
Practice Address - Country:US
Practice Address - Phone:510-259-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPC 11101YP2500X
CAMFC 19873106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional