Provider Demographics
NPI:1649328295
Name:LEVY, BARRIE (LCSW)
Entity type:Individual
Prefix:
First Name:BARRIE
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BARRIE
Other - Middle Name:LEVY
Other - Last Name:PUNDYK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3331 OCEAN PARK BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-3225
Mailing Address - Country:US
Mailing Address - Phone:310-450-0801
Mailing Address - Fax:310-399-0363
Practice Address - Street 1:3331 OCEAN PARK BLVD
Practice Address - Street 2:STE 201
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-3225
Practice Address - Country:US
Practice Address - Phone:310-450-0801
Practice Address - Fax:310-399-0363
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW5884104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker