Organization Active NPI

Stephen G. Levine, PHD, LLC

  • Psychologist
  • Brookfield, WI
National Provider Identifier
1841311123
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1073-057 Issued in WI
Legal business name
STEPHEN G. LEVINE, PHD, LLC
Practice address
17100 W Bluemound Rd
Suite 204
Brookfield, WI 53005-5950
Phone
(262) 391-5780
Fax
(262) 754-3712
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stephen Gary Levine, PH.D.
Title
Psychologist
Phone
(262) 391-5780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 1073-057 WI Primary

Addresses

Primary practice location

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

Mailing address

17100 W Bluemound Rd
Suite 204
Brookfield, WI 53005-5950
Phone (262) 391-5780

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841311123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 W BLUEMOUND RD",
            "address_2": "SUITE 204",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055950",
            "telephone_number": "262-391-5780",
            "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": "262-391-5780",
            "fax_number": "262-754-3712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN G. LEVINE, PHD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "262-391-5780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1073-057",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2020; 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.