Basic Information
| Provider Information | |||||||||
| NPI: | 1023325214 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEVIN | ||||||||
| FirstName: | LEE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 232 LAFAYETTE ST | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019704742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9789793302 | ||||||||
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| Practice Location | |||||||||
| Address1: | 172 LAFAYETTE ST | ||||||||
| Address2: | NSMC, PROFESSIONAL SERVICES BUILDING | ||||||||
| City: | SALEM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019704815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787441386 | ||||||||
| FaxNumber: | 9787404996 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2010 | ||||||||
| LastUpdateDate: | 09/09/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.