Provider Demographics
NPI:1134109416
Name:LEVINE, MARINA (LPC LLP CACII SAP)
Entity Type:Individual
Prefix:MRS
First Name:MARINA
Middle Name:
Last Name:LEVINE
Suffix:
Gender:F
Credentials:LPC LLP CACII SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 SOUTH PENNSYLVANIA AVE
Mailing Address - Street 2:STE C
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-1897
Mailing Address - Country:US
Mailing Address - Phone:517-267-0888
Mailing Address - Fax:517-267-1531
Practice Address - Street 1:1808 SOUTH PENNSYLVANIA AVE
Practice Address - Street 2:STE C
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-1897
Practice Address - Country:US
Practice Address - Phone:517-267-0888
Practice Address - Fax:517-267-1531
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301002591101YA0400X, 101YM0800X
6401003945101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional