Provider Demographics
NPI:1194942953
Name:LEVERICH, ALLYSON (LCSW, PHD)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:LEVERICH
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12441 MEANDERLINE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLEVOIX
Mailing Address - State:MI
Mailing Address - Zip Code:49720-1072
Mailing Address - Country:US
Mailing Address - Phone:906-450-7207
Mailing Address - Fax:
Practice Address - Street 1:1005 MAY ST
Practice Address - Street 2:
Practice Address - City:CHARLEVOIX
Practice Address - State:MI
Practice Address - Zip Code:49720-9380
Practice Address - Country:US
Practice Address - Phone:906-450-7207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health