Individual provider Active NPI

Laurence S Levine, PSYD, ABPP-CN

  • Clinical Neuropsychologist
  • Palm Beach Gardens, FL
National Provider Identifier
1497798631
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY4160 Issued in FL
Practice address
3801 Pga Blvd
Suite 600
Palm Beach Gardens, FL 33410-2758
Phone
(561) 743-0147
Fax
(772) 463-0246
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY4160 FL Primary

Addresses

Primary practice location

3801 Pga Blvd
Suite 600
Palm Beach Gardens, FL 33410-2758

Mailing address

1059 SW Bromelia Ter
Stuart, FL 34997-7145
Phone (561) 743-0147

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1497798631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1059 SW BROMELIA TER",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977145",
            "telephone_number": "561-743-0147",
            "fax_number": "772-463-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 PGA BLVD",
            "address_2": "SUITE 600",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102758",
            "telephone_number": "561-743-0147",
            "fax_number": "772-463-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "LAURENCE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PSYD, ABPP-CN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY4160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.