Provider Demographics
NPI:1174609499
Name:LEVY-MERLIN, BETH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:
Last Name:LEVY-MERLIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 EAGLE ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07068-1723
Mailing Address - Country:US
Mailing Address - Phone:973-226-1505
Mailing Address - Fax:973-226-4105
Practice Address - Street 1:204 EAGLE ROCK AVE
Practice Address - Street 2:
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068-1723
Practice Address - Country:US
Practice Address - Phone:973-226-1505
Practice Address - Fax:973-226-4105
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046347001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical