Individual provider Active NPI

Kathleen Levenson

  • Art Therapist
  • West Islip, NY
National Provider Identifier
1013460013
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Art TherapistTaxonomy code 221700000X
License
P133207 Issued in NY
Practice address
248 Higbie LN FL 1
West Islip, NY 11795-2828
Phone
(631) 867-2501
NPI assigned
Jul 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Art Therapist 221700000X P133207 NY Primary

Addresses

Primary practice location

248 Higbie LN FL 1
West Islip, NY 11795-2828

Mailing address

85 Philadelphia Ave
Massapequa Park, NY 11762-2547
Phone (631) 383-1872

Other practice location 1

11 Route 111
Smithtown, NY 11787-3754
Phone (631) 920-8000

Other names 1

  • Kathleen Roepken Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P133207NYMDArt Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1013460013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 PHILADELPHIA AVE",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117622547",
            "telephone_number": "631-383-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 HIGBIE LN FL 1",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952828",
            "telephone_number": "631-867-2501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Route 111",
            "address_purpose": "LOCATION",
            "city": "Smithtown",
            "state": "NY",
            "postal_code": "117873754",
            "country_code": "US",
            "telephone_number": "631-920-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVENSON",
        "first_name": "KATHLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NY",
            "license": "P133207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "ROEPKEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.