Provider Demographics
NPI:1720270739
Name:LEVINGER, CARL LAWRENCE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:LAWRENCE
Last Name:LEVINGER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 W GOLDLEAF CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90056-1282
Mailing Address - Country:US
Mailing Address - Phone:323-290-8610
Mailing Address - Fax:310-898-1607
Practice Address - Street 1:5110 W GOLDLEAF CIR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90056-1282
Practice Address - Country:US
Practice Address - Phone:323-290-8610
Practice Address - Fax:310-898-1607
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15608103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical