Provider Demographics
NPI:1467098525
Name:JEAN LEVERICH PHD LMSW
Entity Type:Organization
Organization Name:JEAN LEVERICH PHD LMSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LEVERICH
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-657-8274
Mailing Address - Street 1:343 S MAIN ST STE 208
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-2137
Mailing Address - Country:US
Mailing Address - Phone:734-408-1752
Mailing Address - Fax:
Practice Address - Street 1:343 S MAIN ST STE 208
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2137
Practice Address - Country:US
Practice Address - Phone:734-408-1752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-25
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty