Provider Demographics
NPI:1528156239
Name:LEFEVRE, PAUL G (BA LBSW)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:G
Last Name:LEFEVRE
Suffix:
Gender:M
Credentials:BA LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8623 N WAYNE RD
Mailing Address - Street 2:SUITE 325
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185
Mailing Address - Country:US
Mailing Address - Phone:734-427-1144
Mailing Address - Fax:734-742-0608
Practice Address - Street 1:8623 N WAYNE RD
Practice Address - Street 2:SUITE 325
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185
Practice Address - Country:US
Practice Address - Phone:734-427-1144
Practice Address - Fax:734-742-0608
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL794880104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker