Jeffrey Mitchell Levine, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

001225 Issued in CT

Practice address

100 Kingsley Rd
Lebanon, CT 06249

Phone

(860) 534-1592

NPI assigned

Oct 3, 2006

Last updated

Sep 1, 2022By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 19, 2018 through Apr 19, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1346334042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGSLEY RD",
            "city": "LEBANON",
            "state": "CT",
            "postal_code": "06249",
            "telephone_number": "860-534-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KINGSLEY RD",
            "city": "LEBANON",
            "state": "CT",
            "postal_code": "06249",
            "telephone_number": "860-534-1592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "JEFFREY",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "001225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CBHP4848JL",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Irene Haddad, LO
• Nusie M Halpine, LCSW
• Lillian Julian, LMSW
• Lebanon Board of Education
• Lebanon Volunteer Fire Department
• Maple Stone Counseling, LLC
• Heather Massicotte
• Kaitlyn A Murphy, M.ED. M.S. BCBA, LBA
• Thomas E Pawlowski
• John Howe Reed Sr., MS LADC

• Psychologist in Lebanon, CT
• Providers in Lebanon, CT by specialty
• Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.