Individual provider Active NPI

Marisha Levine, LCSW

  • Mental Health Counselor
  • Little Rock, AR
National Provider Identifier
1609246073
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8386-C Issued in AR
Practice address
20400 Colonel Glenn Rd
Little Rock, AR 72210-5323
Phone
(501) 821-5500
NPI assigned
Sep 29, 2015
Last updated
May 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8386-C AR Primary

Addresses

Primary practice location

20400 Colonel Glenn Rd
Little Rock, AR 72210-5323

Mailing address

20400 Colonel Glenn Rd
Little Rock, AR 72210-5323
Phone (501) 821-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210517000368 AR Practitioner - Clinical Social Worker 2668881061 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Youth Home Inc CurrentSince Apr 1, 2021 Accepting new patients

Locations

10 Corporate Hill Dr
Ste 330
Little Rock, AR 72205
Phone (501) 954-7470

20400 Colonel Glenn Rd
Little Rock, AR 72210

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/youthhome/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1609246073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20400 COLONEL GLENN RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722105323",
            "telephone_number": "501-821-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20400 COLONEL GLENN RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722105323",
            "telephone_number": "501-821-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "MARISHA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-29",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "8386-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.