Provider Demographics
NPI:1013136514
Name:DELEVIE, M KERRIE
Entity type:Individual
Prefix:
First Name:M
Middle Name:KERRIE
Last Name:DELEVIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KERRIE
Other - Middle Name:M
Other - Last Name:DELEVIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLP
Mailing Address - Street 1:4444 RYANT DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1034
Mailing Address - Country:US
Mailing Address - Phone:248-249-1520
Mailing Address - Fax:
Practice Address - Street 1:7151 N MAIN ST # 100
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-1582
Practice Address - Country:US
Practice Address - Phone:248-922-7419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301005696103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical