Provider Demographics
NPI:1881755031
Name:LEVIN, KAREN R (LMSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:R
Last Name:LEVIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 PARKLAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2049
Mailing Address - Country:US
Mailing Address - Phone:734-677-2928
Mailing Address - Fax:734-677-2928
Practice Address - Street 1:408 N 1ST ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-3304
Practice Address - Country:US
Practice Address - Phone:734-677-2928
Practice Address - Fax:734-677-2928
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010146491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0N21880Medicare ID - Type Unspecified