Provider Demographics
NPI:1245469451
Name:LEVINE, LISA F
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:F
Last Name:LEVINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 W PALMETTO PARK RD STE 210
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3430
Mailing Address - Country:US
Mailing Address - Phone:954-815-5252
Mailing Address - Fax:561-988-9959
Practice Address - Street 1:7000 W PALMETTO PARK RD STE 210
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3430
Practice Address - Country:US
Practice Address - Phone:954-815-5252
Practice Address - Fax:561-988-9959
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health