Provider Demographics
NPI:1316901614
Name:LEVINE, GREGORY P (LPC)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:P
Last Name:LEVINE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:37 MASE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849-2112
Mailing Address - Country:US
Mailing Address - Phone:973-663-0565
Mailing Address - Fax:973-326-1179
Practice Address - Street 1:185 ROUTE 183
Practice Address - Street 2:
Practice Address - City:STANHOPE
Practice Address - State:NJ
Practice Address - Zip Code:07874
Practice Address - Country:US
Practice Address - Phone:973-426-1640
Practice Address - Fax:973-426-1641
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00334300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional