Provider Demographics
NPI:1336541416
Name:LEVINSON, SUSAN LYNNE (LPC-S)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:LYNNE
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:LYNNE
Other - Middle Name:
Other - Last Name:LEVINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC-S
Mailing Address - Street 1:8 CONCORD CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-9059
Mailing Address - Country:US
Mailing Address - Phone:512-695-1604
Mailing Address - Fax:
Practice Address - Street 1:821 W 11TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2009
Practice Address - Country:US
Practice Address - Phone:512-695-1604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-21
Last Update Date:2014-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12227101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional