ETHAN R. LEVINE, PH.D.
NPI 1972002004
Psychologist - Clinical in Raleigh, NC

Q: What is Ethan R. Levine, Ph.D.'s NPI number?

The NPI number for Ethan R. Levine, Ph.D. is 1972002004. It was assigned to this organization in the NPPES registry on February 5, 2018.

Q: What is Ethan R. Levine, Ph.D.'s specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since February 05, 2018

11937 STRAIGHT A WAY LN, RALEIGH, NC 27613(919) 264-3755(919) 846-9231 Get Directions Write a Review

NPPES record last updated: February 5, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Ethan R. Levine, Ph.d. NPPES

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

ETHAN R. LEVINE, PH.D. (NPI 1972002004) is a healthcare organization registered as a clinical in Raleigh, North Carolina and active in the NPI registry since February 2018. The organization lists Ethan Roy Levine, Managing Director, as its authorized official.

NPPES Registry Identity

NPI1972002004

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameETHAN R. LEVINE, PH.D.

Location Address11937 STRAIGHT A WAY LNRaleigh, NC 27613-7105

Mailing Address11937 Straight A Way LnRaleigh, NC 27613-7105 · (919) 264-3755 · Fax (919) 846-9231

Phone(919) 264-3755

Fax(919) 846-9231

Organization SubpartNo

Authorized OfficialEthan Roy LevineManaging Director · (919) 264-3755

Enumeration DateFebruary 5, 2018

✔ NPI 1972002004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in NC · 650

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

11937 STRAIGHT A WAY LN, Raleigh, NC 27613

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan R. Levine, Ph.D.'s NPI number?

The NPI number for Ethan R. Levine, Ph.D. is 1972002004. It was assigned to this organization in the NPPES registry on February 5, 2018.

Where is Ethan R. Levine, Ph.D. located?

Ethan R. Levine, Ph.D. is located at 11937 Straight A Way Ln, Raleigh, NC 27613. The listed phone number is (919) 264-3755.

What is Ethan R. Levine, Ph.D.'s specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Ethan R. Levine, Ph.D. was last updated on February 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.