Doctor Name: | ADAM MICHAEL LEVINE |
NPI Number: | 1043468663 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW |
License Number: | |
Business Practice Address: | 902 S Myrtle Ave Monrovia, CA - 910163427 |
Business Phone Number: | 6263573258 |
Business Fax Number: | |
Mailing Address: | 4626 Russell Ave, Apartment #2 LOS ANGELES |
State: | CA |
Postal Code: | 900274223 |
Phone Number: | 9094569197 |
Fax Number: | |
NPI Enumeration Date: | 09/08/2008 |
NPI Last Update Date: | 06/09/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |