Provider Demographics
NPI:1649363250
Name:LEVERING, KAY ILENE (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:KAY
Middle Name:ILENE
Last Name:LEVERING
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:ILENE
Other - Last Name:KLEINSCHNITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 E GENESEE ST
Mailing Address - Street 2:SUITE 217
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-3130
Mailing Address - Country:US
Mailing Address - Phone:315-422-0300
Mailing Address - Fax:315-479-8455
Practice Address - Street 1:600 E GENESEE ST
Practice Address - Street 2:SUITE 217
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3130
Practice Address - Country:US
Practice Address - Phone:315-422-0300
Practice Address - Fax:315-479-8455
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0348501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY53174JMedicare ID - Type Unspecified