Provider Demographics
NPI:1235612292
Name:LEVINE, JOSHUA PHILIP (LCSW)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:PHILIP
Last Name:LEVINE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:FANWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07023-1719
Mailing Address - Country:US
Mailing Address - Phone:646-656-5271
Mailing Address - Fax:
Practice Address - Street 1:16 SHADY LN
Practice Address - Street 2:
Practice Address - City:FANWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07023-1719
Practice Address - Country:US
Practice Address - Phone:516-361-1518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0879271041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical