Provider Demographics
NPI:1053536540
Name:LEVIN, RICHARD DAVID (LMFT)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:DAVID
Last Name:LEVIN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3709 EFFINGHAM PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-1427
Mailing Address - Country:US
Mailing Address - Phone:323-960-5007
Mailing Address - Fax:
Practice Address - Street 1:588 N LARCHMONT BLVD
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-1306
Practice Address - Country:US
Practice Address - Phone:323-960-5007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT29124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist