Dr. Ethan R Levine
Psychologist Health Service Clinical Psychologist Rehabilitation Psychologist and 3 more
101 Cabarrus Ave E
Concord
, North Carolina 28025-3699
Dr. Ethan R Levine
Psychologist Health Service Clinical Psychologist Rehabilitation Psychologist and 3 more
101 Cabarrus Ave E
Concord
, North Carolina 28025-3699
(855) 857-7333
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About
Features
Specialties
- Psychologist
- Adult Development & Aging Psychologist
- Clinical Psychologist
- Clinical Child & Adolescent Psychologist
- Exercise & Sports Psychologist
- Health Service
- Rehabilitation Psychologist
Languages spoken
- English
Location
First Address
- Dr. Ethan R Levine
- 101 Cabarrus Ave E
- Concord, NC
- Zip : 28025-3699
- Fax : (855) 857-7333
- Phone : (888) 849-7379
Second Address
- Dr. Ethan R Levine
- 101 Cabarrus Ave E
- Concord, NC
- Zip : 28025-3699
- Fax : (855) 857-7333
- Phone : (888) 849-7379
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 102L00000X | Psychologist | ||
| N | 103T00000X | Psychologist | ||
| Y | 103TA0700X | Adult Development & Aging Psychologist | ||
| N | 103G00000X | Clinical Psychologist | 650 | NC |
| N | 103TC0700X | Clinical Psychologist | 650 | NC |
| N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
| N | 103TE1100X | Exercise & Sports Psychologist | ||
| N | 103TH0100X | Health Service | ||
| N | 103TR0400X | Rehabilitation Psychologist |
National Provider Identifier
| NPI | 1538300025 |
|---|---|
| Provider Name | Dr. Ethan R Levine |
| First Address | Concord, NC 28025-3699 |
| Second Address | Concord, NC 28025-3699 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/03/2009 |
| Last Update Date | 08/04/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 14040 | BCBS (01) | NC |
| 6001139 | (05) | NC |
| P01164443 | RR MEDICARE (01) | NC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.