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Contact Information

ETHAN R LEVINE, PhD
101 CABARRUS AVE E
CONCORD, NC28025-3699
 Phone: 888-849-7379
 Fax: 855-857-7333
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adult Development & Aging

103TA0700X 62 Psychologist, Clinical
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
 

Exercise & Sports

103TE1100X 62 Psychologist, Clinical
 

Health Service

103TH0100X 62 Psychologist, Clinical
 

Psychologist

103T00000X 62 Psychologist, Clinical
 

Rehabilitation

103TR0400X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for ETHAN R LEVINE · (Male)

NPI Number 1538300025
Status Active
Credentials PhD
Entity Individual
Enumeration date 03/13/2009
Last updated 04/08/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 650
  • NC Medicaid 6001139
  • NC Other 14040 BCBS
  • NC Other P01164443 RR MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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