DR. ETHAN R LEVINE PH.D.
NPI 1538300025
Psychologist - Adult Development & Aging in Concord, NC

Q: What is Ethan Levine's NPI number?

The NPI number for Ethan Levine is 1538300025. It was assigned to this individual provider in the NPPES registry on March 13, 2009.

Q: What is Ethan Levine's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Adult Development & Aging, with taxonomy code 103TA0700X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Levine was last updated on April 8, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 13, 2009PECOS Enrolled

101 CABARRUS AVE E, CONCORD, NC 28025(888) 849-7379(855) 857-7333 Get Directions Write a Review

NPPES record last updated: April 8, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 8, 2020, Feb 10, 2017 (2 updates tracked since 2017).

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About Dr. Ethan R Levine Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ETHAN R LEVINE PH.D. (NPI 1538300025) is an individual adult development & aging provider in Concord, North Carolina and active in the NPI registry since March 2009. He is enrolled in Medicare PECOS and is a graduate of Other (1977).

NPPES Registry Identity

NPI1538300025

Entity TypeIndividualMale

Primary Taxonomy103TA0700X

Provider Legal NameDR. ETHAN R LEVINECredential: PH.D.

Location Address101 CABARRUS AVE EConcord, NC 28025-3699

Mailing Address101 Cabarrus Ave EConcord, NC 28025-3699 · (888) 849-7379 · Fax (855) 857-7333

Phone(888) 849-7379

Fax(855) 857-7333

Sole ProprietorNo

Medical School CMSOtherGraduated 1977

Enumeration DateMarch 13, 2009

Last NPPES UpdateApril 8, 20202 updates tracked since enumeration

NPPES CertifiedApril 8, 2020

✔ NPI 1538300025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyPsychologist · Adult Development & AgingBehavioral Health & Social Service Providers

Taxonomy Code103TA0700X

Definition

A psychologist who specializes in geropsychology, which applies the knowledge and methods of psychology to understanding and helping older persons and their families to maintain well-being, overcome problems and achieve maximum potential during later life. Professional geropsychology appreciates the wide diversity among older adults, the complex ethical issues that can arise in geriatric practice and the importance of interdisciplinary models of care.

Also ListedPsychologistTaxonomy 103T00000X

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 650 (NC)

Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X

Also ListedPsychologist · Exercise & SportsTaxonomy 103TE1100X

Also ListedPsychologist · Health ServiceTaxonomy 103TH0100X

Also ListedPsychologist · RehabilitationTaxonomy 103TR0400X

101 CABARRUS AVE E, Concord, NC 28025

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Other Identifiers 3

OtherP01164443NC · Rr Medicare

Other14040NC · Bcbs

Medicaid6001139NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Blue Cross and Blue Shield of NC and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ethan R Levine Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3274708722

PECOS Enrollment IDI20111212000189

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 30 minutes 90832

Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 30-minute session, the therapist helps you explore feelings, thoughts, and behaviors to better understand yourself and manage life's challenges.

58 services13 patients

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JASON K FREEBURNE ARNP

Nurse Practitioner (Acute Care)