Provider Demographics
NPI:1124853916
Name:BELKIN, STACEY EVA-LEVINE (MA LLP)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:EVA-LEVINE
Last Name:BELKIN
Suffix:
Gender:F
Credentials:MA LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:584 PILGRIM AVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-1211
Mailing Address - Country:US
Mailing Address - Phone:248-797-8917
Mailing Address - Fax:
Practice Address - Street 1:3138 HILTON RD
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1039
Practice Address - Country:US
Practice Address - Phone:248-232-2555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6361003114103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical