Provider Demographics
NPI:1205528825
Name:LEVY, REBECCA NICHOLLE (MA, NCC, LPC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:NICHOLLE
Last Name:LEVY
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:ROWAN
Other - Middle Name:
Other - Last Name:LEVY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, NCC, LPC
Mailing Address - Street 1:100 S BROAD ST
Mailing Address - Street 2:SUITE 2210
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19110-0112
Mailing Address - Country:US
Mailing Address - Phone:510-550-5318
Mailing Address - Fax:
Practice Address - Street 1:100 S BROAD ST
Practice Address - Street 2:SUITE 2210
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19110-0112
Practice Address - Country:US
Practice Address - Phone:510-550-5318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015696101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional