Provider Demographics
NPI:1134189806
Name:LEVIN, STEPHEN J (DSW MSW)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:LEVIN
Suffix:
Gender:M
Credentials:DSW MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:887 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598
Mailing Address - Country:US
Mailing Address - Phone:212-262-3383
Mailing Address - Fax:516-295-9184
Practice Address - Street 1:887 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2021
Practice Address - Country:US
Practice Address - Phone:212-262-3383
Practice Address - Fax:516-295-9184
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-25
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPROO897211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N08421Medicare UPIN