Individual
DR. ELAINE S. LEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1395 MISSOURI AVE, LAS CRUCES, NM 88001-5327
(505) 522-5466
Mailing address
1395 MISSOURI AVE, LAS CRUCES, NM 88001-5327
(575) 522-5466
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
189
NM
103TP0016X
Prescribing (Medical) Psychologist
Primary
0001
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000N5897
—
NM
05
—
VNM0191
—
NM
Enumeration date
02/23/2007
Last updated
12/09/2022
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