Provider Demographics
NPI:1770995763
Name:STUART J. LEVINSON, LCSW, P.C.
Entity type:Organization
Organization Name:STUART J. LEVINSON, LCSW, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:LEVINSON
Authorized Official - Suffix:
Authorized Official - Credentials:JD, LCSW
Authorized Official - Phone:212-308-5363
Mailing Address - Street 1:285 AVENUE C
Mailing Address - Street 2:SUITE 11-H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2301
Mailing Address - Country:US
Mailing Address - Phone:212-308-5363
Mailing Address - Fax:212-308-5363
Practice Address - Street 1:280 MADISON AVE
Practice Address - Street 2:SUITE 1108
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0801
Practice Address - Country:US
Practice Address - Phone:212-308-5363
Practice Address - Fax:212-308-5363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-24
Last Update Date:2014-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR049702-1302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNT5941OtherMEDICARE PTAN