Provider Demographics
NPI:1700100898
Name:LEVINE COUNSELING & CONSULTING, INC.
Entity Type:Organization
Organization Name:LEVINE COUNSELING & CONSULTING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:262-391-5752
Mailing Address - Street 1:17100 W BLUEMOUND RD STE 204
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-5950
Mailing Address - Country:US
Mailing Address - Phone:262-391-5752
Mailing Address - Fax:262-754-3712
Practice Address - Street 1:17100 W BLUEMOUND RD
Practice Address - Street 2:STE. 204
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-5950
Practice Address - Country:US
Practice Address - Phone:262-391-5752
Practice Address - Fax:262-754-3712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3099-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43553600Medicaid