Basic Information
| Provider Information | |||||||||
| NPI: | 1578595807 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEVIN | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | M.S.W. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 34651 VALLEY FORGE DR | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483313205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483301485 | ||||||||
| FaxNumber: | 2482130521 | ||||||||
| Practice Location | |||||||||
| Address1: | 29201 TELEGRAPH RD | ||||||||
| Address2: | |||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480341331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482130501 | ||||||||
| FaxNumber: | 2482130521 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 1041C0700X | 6801014151 | MI | X | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041S0200X | 6801014151 | MI | X | Behavioral Health & Social Service Providers | Social Worker | School |
No ID Information.