Provider Demographics
NPI:1508741679
Name:LEVELL, BEREK ALIN (MAMFT, LMFT)
Entity type:Individual
Prefix:
First Name:BEREK
Middle Name:ALIN
Last Name:LEVELL
Suffix:
Gender:M
Credentials:MAMFT, LMFT
Other - Prefix:
Other - First Name:BEREK
Other - Middle Name:ALIN
Other - Last Name:BRACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3367 STATE ROAD 44
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46151-6668
Mailing Address - Country:US
Mailing Address - Phone:812-989-3175
Mailing Address - Fax:
Practice Address - Street 1:727 W 2ND ST STE 202
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-2209
Practice Address - Country:US
Practice Address - Phone:812-353-3454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35002489A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist