Active NPI
Jesse Bernard Levine, PH.D.
- Clinical Psychologist
- Port Washington, NY
National Provider Identifier
1508023516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 005386
- Practice address
- 6 Bernard St
Port Washington, NY 11050-2902 - Phone
- (516) 767-2464
- Fax
- (516) 944-6452
- NPI assigned
- May 19, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 005386 | NY | Primary |
Addresses
Primary practice location
6 Bernard St
Port Washington, NY 11050-2902
Mailing address
6 Bernard St
Port Washington, NY 11050-2902
Phone (516) 767-2464
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1508023516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 BERNARD ST",
"city": "PORT WASHINGTON",
"state": "NY",
"postal_code": "110502902",
"telephone_number": "516-767-2464",
"fax_number": "516-944-6452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 BERNARD ST",
"city": "PORT WASHINGTON",
"state": "NY",
"postal_code": "110502902",
"telephone_number": "516-767-2464",
"fax_number": "516-944-6452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVINE",
"first_name": "JESSE",
"middle_name": "BERNARD",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-19",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "005386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Washington, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.