Provider Demographics
NPI:1073751392
Name:CAREY, LEVENIA MARIE (MED/LPC)
Entity Type:Individual
Prefix:
First Name:LEVENIA
Middle Name:MARIE
Last Name:CAREY
Suffix:
Gender:F
Credentials:MED/LPC
Other - Prefix:
Other - First Name:LEVENIA
Other - Middle Name:MARIE
Other - Last Name:WILLIAMS-MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1019 KINKEAD RD
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-7704
Mailing Address - Country:US
Mailing Address - Phone:918-429-8184
Mailing Address - Fax:918-426-5439
Practice Address - Street 1:1019 KINKEAD RD
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-7704
Practice Address - Country:US
Practice Address - Phone:918-429-8184
Practice Address - Fax:918-426-5439
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2891101YP2500X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200263700AMedicaid