Basic Information
| Provider Information | |||||||||
| NPI: | 1164070165 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEVKOVICH | ||||||||
| FirstName: | REGINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 652 WASHINGTON ST APT 2 | ||||||||
| Address2: | |||||||||
| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024464549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8572077156 | ||||||||
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| Practice Location | |||||||||
| Address1: | SPAULDING NURSING AND THERAPY CENTER-BRIGHTON | ||||||||
| Address2: | 100 NORTH BEACON STREET | ||||||||
| City: | BRIGHTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177269700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2019 | ||||||||
| LastUpdateDate: | 09/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 221383 | MA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.