Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Justin Charles Levy, LICSW

Individual provider Mental Health Counselor · NPI 1063381028

Justin Charles Levy, LICSW is a Clinical Social Worker in Minneapolis, Minnesota. Qualified in 2023, 3 years ago. Practices as a sole proprietor. Licensed in Minnesota.

Years since qualifying
3
Licensed in
MN
In the registry since
2025
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

1612C W Lake St
Minneapolis, MN 55408-2549
Phone: (612) 202-9552
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 32300 (MN)

Record details

NPI number1063381028
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorYes
NPI enumeratedOctober 30, 2025
Last updated in NPPESOctober 30, 2025
Certification dateOctober 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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