Provider Demographics
NPI:1871572727
Name:LEVINE, KAREN (MSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:EAST CHATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12060-2506
Mailing Address - Country:US
Mailing Address - Phone:518-392-5109
Mailing Address - Fax:
Practice Address - Street 1:77 RUSSELL RD
Practice Address - Street 2:HILLTOWN COMMUNITY HEALTH CENTER
Practice Address - City:HUNTINGTON
Practice Address - State:MA
Practice Address - Zip Code:01050-9777
Practice Address - Country:US
Practice Address - Phone:413-667-3009
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA113320104100000X
CT006073104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA35316OtherHEALTH NEW ENGLAND
MA361232OtherMHN