Active NPI
Mark David Levine Sr., LPC
- Professional Counselor
- Mesa, AZ
National Provider Identifier
1376996462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 22623
- Practice address
- 4111 E Valley Auto Dr Ste 106
Mesa, AZ 85206-4607 - Phone
- (657) 234-4718
- NPI assigned
- Jul 13, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 22623 | AZ | Primary |
Addresses
Primary practice location
4111 E Valley Auto Dr Ste 106
Mesa, AZ 85206-4607
Mailing address
4111 E Valley Auto Dr Ste 106
Mesa, AZ 85206-4607
Phone (657) 234-4718
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Buckeye, AZ 85396
Phone (240) 201-3386
1910 S Stapley Dr
Suite 209
Mesa, AZ 85204-6679
Phone (888) 362-5953
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22623 | AZ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Care Center, LLC | Professional | Current | Accepting new patients |
Locations
1910 S Stapley Dr
Ste 209
Mesa, AZ 85204
Phone (480) 351-8020
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703116800000",
"number": "1376996462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4111 E VALLEY AUTO DR STE 106",
"city": "MESA",
"state": "AZ",
"postal_code": "852064607",
"telephone_number": "657-234-4718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4111 E VALLEY AUTO DR STE 106",
"city": "MESA",
"state": "AZ",
"postal_code": "852064607",
"telephone_number": "657-234-4718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVINE",
"first_name": "MARK",
"middle_name": "DAVID",
"name_suffix": "Sr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-13",
"last_updated": "2023-12-21",
"certification_date": "2023-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "22623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.