Provider Demographics
NPI:1255594743
Name:LEVENTHAL, JANIS (LCSW)
Entity type:Individual
Prefix:
First Name:JANIS
Middle Name:
Last Name:LEVENTHAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 W 95TH ST
Mailing Address - Street 2:APT.1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6610
Mailing Address - Country:US
Mailing Address - Phone:917-734-6191
Mailing Address - Fax:
Practice Address - Street 1:146 W 95TH ST
Practice Address - Street 2:APT.1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6610
Practice Address - Country:US
Practice Address - Phone:917-734-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-06
Last Update Date:2008-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY-LEVJ124-01041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical