Provider Demographics
NPI:1255791455
Name:LEVY, ELYEHU (MSW)
Entity type:Individual
Prefix:
First Name:ELYEHU
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 MERRIWOLD LN
Mailing Address - Street 2:
Mailing Address - City:DEEP RIVER
Mailing Address - State:CT
Mailing Address - Zip Code:06417-2125
Mailing Address - Country:US
Mailing Address - Phone:860-526-9146
Mailing Address - Fax:
Practice Address - Street 1:28 HUNTINGTON ST
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-6111
Practice Address - Country:US
Practice Address - Phone:860-443-5328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker