Individual provider Active NPI

Christine Mary Levine, PSY.D.

  • Professional Counselor
  • Brookfield, WI
National Provider Identifier
1558445510
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3099-125 Issued in WI
Practice address
17100 W Bluemound Rd
Suite 204
Brookfield, WI 53005-5950
Phone
(262) 391-5752
Fax
(262) 754-3712
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3099-125 WI Primary

Addresses

Primary practice location

17100 W Bluemound Rd
Suite 204
Brookfield, WI 53005-5950

Mailing address

1270 Mary Hill Cir
Hartland, WI 53029-8006
Phone (262) 367-8298

Other identifiers 1

IdentifierTypeStateIssuer
43553600MedicaidWI

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

State licenses

LicenseStateTypeSpecialty
3099-125WIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268784000000",
    "number": "1558445510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 MARY HILL CIR",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530298006",
            "telephone_number": "262-367-8298",
            "fax_number": "262-754-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 W BLUEMOUND RD",
            "address_2": "SUITE 204",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055950",
            "telephone_number": "262-391-5752",
            "fax_number": "262-754-3712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "CHRISTINE",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2010-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3099-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43553600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.