Provider Demographics
NPI:1508811290
Name:WING, KARLA LEIGH (MSW LMSW, ACSW)
Entity Type:Individual
Prefix:MS
First Name:KARLA
Middle Name:LEIGH
Last Name:WING
Suffix:
Gender:F
Credentials:MSW LMSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 HARWICH LN
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-9347
Mailing Address - Country:US
Mailing Address - Phone:517-750-1443
Mailing Address - Fax:
Practice Address - Street 1:3907 HARWICH LN
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-9347
Practice Address - Country:US
Practice Address - Phone:517-750-1443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010868181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8008975540OtherTRADITIONAL BLUE CROSS BL
MI8008975540OtherTRADITIONAL BLUE CROSS BL