Individual
BASHA LEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
908 VERMONT AVE, LAKEWOOD, NJ 08701-5997
(732) 961-7363
Mailing address
17 CORNELIUS ST, LAKEWOOD, NJ 08701-2016
(732) 961-7363
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00500400
NJ
Other
Enumeration date
01/29/2013
Last updated
03/07/2017
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