Provider Demographics
NPI:1740368133
Name:LEFKOWITZ, CARIN MARICE (PSYD)
Entity type:Individual
Prefix:DR
First Name:CARIN
Middle Name:MARICE
Last Name:LEFKOWITZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 59
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-0059
Mailing Address - Country:US
Mailing Address - Phone:215-869-6571
Mailing Address - Fax:
Practice Address - Street 1:303 W LANCASTER AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-3938
Practice Address - Country:US
Practice Address - Phone:215-869-6571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016115103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical