Jack Brian Levin, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

118144 Issued in MA

Practice address

800 W Cummings Park
Suite 3000
Woburn, MA 01801-6372

Phone

(617) 417-4535

NPI assigned

Oct 19, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1083999338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 LEACH ST",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019704710",
            "telephone_number": "617-417-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W CUMMINGS PARK",
            "address_2": "SUITE 3000",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016372",
            "telephone_number": "617-417-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVIN",
        "first_name": "JACK",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-19",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "118144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Lerman
• Jennifer Leslie, PSY.D
• Kristina Marie Lessard
• Kimberly Levasseur, RRT
• Benjamin Francis Levin
• Rachel Levitt, BCBA
• Blake Alexander Levitts, PT
• Martin Gonzales Lewerk, LICSW
• Elaine Lewin, PT
• Lewis Physical Therapy PLLC

• Clinical Social Worker in Woburn, MA
• Providers in Woburn, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.