Provider Demographics
NPI:1740815141
Name:LEVINE, RUTH LIEBAN (LCSW)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:LIEBAN
Last Name:LEVINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21055 YACHT CLUB DR APT 2308
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-4091
Mailing Address - Country:US
Mailing Address - Phone:301-787-6564
Mailing Address - Fax:
Practice Address - Street 1:21055 YACHT CLUB DR APT 2308
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-4091
Practice Address - Country:US
Practice Address - Phone:301-787-6564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-05
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW170221041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health