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Individual

DR. JEFFREY MITCHELL LEVINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
100 KINGSLEY RD, LEBANON, CT 06249
(860) 534-1592
Mailing address
100 KINGSLEY RD, LEBANON, CT 06249
(860) 534-1592

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
001225
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CBHP4848JL
CT
Enumeration date
10/03/2006
Last updated
09/01/2022
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