Doctor Name: | MR. BRADLEY OLIVER LEVY |
NPI Number: | 1003098484 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LICSW |
License Number: | 115769 |
Business Practice Address: | 1353 Dorchester Ave Boston, MA - 021222932 |
Business Phone Number: | 6172883230 |
Business Fax Number: | 6172820954 |
Mailing Address: | 1353 Dorchester Ave, DORCHESTER |
State: | MA |
Postal Code: | 021222932 |
Phone Number: | 6172883230 |
Fax Number: | 6172820954 |
NPI Enumeration Date: | 11/28/2007 |
NPI Last Update Date: | 12/13/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 115769 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |