Provider Demographics
NPI:1780773309
Name:LEVNER, LAWRENCE (MSW)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:LEVNER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5206 MARLYN DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-1949
Mailing Address - Country:US
Mailing Address - Phone:301-229-8126
Mailing Address - Fax:301-576-4213
Practice Address - Street 1:5206 MARLYN DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-1949
Practice Address - Country:US
Practice Address - Phone:301-229-8126
Practice Address - Fax:301-576-4213
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD042411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD715690Medicare ID - Type Unspecified