Provider Demographics
NPI:1891671822
Name:LEVARIO, BRIAN E (MHC-LP)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:E
Last Name:LEVARIO
Suffix:
Gender:M
Credentials:MHC-LP
Other - Prefix:
Other - First Name:BLAZE
Other - Middle Name:E
Other - Last Name:LEVARIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MHC-LP
Mailing Address - Street 1:40 BRUCKNER BLVD APT 209
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-0056
Mailing Address - Country:US
Mailing Address - Phone:520-665-8562
Mailing Address - Fax:
Practice Address - Street 1:16 E 41ST ST UNIT 5C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6217
Practice Address - Country:US
Practice Address - Phone:520-665-8562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty