Provider Demographics
NPI:1942419007
Name:LEVIN, RIVIENNE MICHELLE (LISW CCBT)
Entity type:Individual
Prefix:
First Name:RIVIENNE
Middle Name:MICHELLE
Last Name:LEVIN
Suffix:
Gender:F
Credentials:LISW CCBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24001 WEST RD
Mailing Address - Street 2:
Mailing Address - City:OLMSTED FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44138-2334
Mailing Address - Country:US
Mailing Address - Phone:440-891-8952
Mailing Address - Fax:
Practice Address - Street 1:303 E BAGLEY RD
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017-2040
Practice Address - Country:US
Practice Address - Phone:440-260-8370
Practice Address - Fax:440-260-8390
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI57251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical