Provider Demographics
NPI:1841289584
Name:LEVY, MARILYN DIANE (LPC)
Entity type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:DIANE
Last Name:LEVY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7902 E HAYNE PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-4211
Mailing Address - Country:US
Mailing Address - Phone:520-721-8434
Mailing Address - Fax:520-298-9637
Practice Address - Street 1:7902 E HAYNE PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-4211
Practice Address - Country:US
Practice Address - Phone:520-721-8434
Practice Address - Fax:520-298-9637
Is Sole Proprietor?:No
Enumeration Date:2005-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC0244101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health