Levine, Ethan R
Levine, Ethan R is an individual health care provider with primary practice located at 101 Cabarrus Ave E , Concord NC 28025-3699. He recently has 7 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Exercise & Sports, Behavioral Health & Social Service Providers / Health Service, Behavioral Health & Social Service Providers / Rehabilitation, Behavioral Health & Social Service Providers / Adult Development & Aging. Behavioral Health & Social Service Providers / Adult Development & Aging is his primary health care specialty. Levine, Ethan R can be contacted via phone (888) 849-7379.Contact Information
Primary practice address
101 Cabarrus Ave E
Concord NC 28025-3699
Phone: (888) 849-7379
Fax: (855) 857-7333
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | ||
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 650 | North Carolina |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | ||
| Behavioral Health & Social Service Providers / Exercise & Sports | 103TE1100X | ||
| Behavioral Health & Social Service Providers / Health Service | 103TH0100X | ||
| Behavioral Health & Social Service Providers / Rehabilitation | 103TR0400X | ||
| Behavioral Health & Social Service Providers / Adult Development & Aging | 103TA0700X |
Profile Details
| NPI number | 1538300025 |
|---|---|
| LBN Legal business name | Levine, Ethan R |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 13th, 2009 |
| Last updated | Apr 8th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538300025 | NPPES |
| North Carolina | Other | 14040 | BCBS |
| North Carolina | MEDICAID | 6001139 | BCBS |
| North Carolina | Other | P01164443 | BCBS |
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