Provider Demographics
NPI:1720136187
Name:LEVY, BRUCE IRWIN (MS)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:IRWIN
Last Name:LEVY
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5741 ARAPAHOE AVE
Mailing Address - Street 2:BLDG. 4
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1341
Mailing Address - Country:US
Mailing Address - Phone:303-443-0552
Mailing Address - Fax:303-443-1547
Practice Address - Street 1:5741 ARAPAHOE AVE
Practice Address - Street 2:BLDG. 4
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1341
Practice Address - Country:US
Practice Address - Phone:303-443-0552
Practice Address - Fax:303-443-1547
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor