Provider Demographics
NPI:1679649941
Name:FLEVARIS, CAROLE ANN (LMSW)
Entity Type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:ANN
Last Name:FLEVARIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:DR
Other - First Name:CAROLE
Other - Middle Name:ANN
Other - Last Name:FLEVARIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:3515 RAVINEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-1648
Mailing Address - Country:US
Mailing Address - Phone:248-888-9437
Mailing Address - Fax:
Practice Address - Street 1:28000 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-2468
Practice Address - Country:US
Practice Address - Phone:810-227-1211
Practice Address - Fax:810-220-5509
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010160781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical