Individual provider Active NPI

Jacob Levin, PHD

  • Clinical Psychologist
  • Bronx, NY
National Provider Identifier
1306765854
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P137208 Issued in NY
Practice address
2058 Jerome Ave Unit 3
Bronx, NY 10453-1817
Phone
(914) 844-5828
NPI assigned
Jul 10, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P137208 NY Primary

Addresses

Primary practice location

2058 Jerome Ave Unit 3
Bronx, NY 10453-1817

Mailing address

600 Columbus Ave Apt 11R
New York, NY 10024-1439
Phone (914) 844-5828

Other practice location 1

3550 Jerome Ave Unit 1
Bronx, NY 10467-1005
Phone (914) 844-5828

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

NPI Registry JSON

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

{
    "created_epoch": "1783641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1306765854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COLUMBUS AVE APT 11R",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100241439",
            "telephone_number": "914-844-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2058 JEROME AVE UNIT 3",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104531817",
            "telephone_number": "914-844-5828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3550 Jerome Ave Unit 1",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104671005",
            "country_code": "US",
            "telephone_number": "914-844-5828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVIN",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-10",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "P137208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.