Provider Demographics
NPI:1265929228
Name:SEVIGNY, MICHELE KAREN (LMSW)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:KAREN
Last Name:SEVIGNY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 DOWNING WAY
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1994
Mailing Address - Country:US
Mailing Address - Phone:845-629-7552
Mailing Address - Fax:
Practice Address - Street 1:101 STAGE RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-3512
Practice Address - Country:US
Practice Address - Phone:845-827-6227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093944-1171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator