Provider Demographics
NPI:1831794296
Name:LEVAN, CALLIE
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:LEVAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 S MARGINAL RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-1072
Mailing Address - Country:US
Mailing Address - Phone:216-221-7588
Mailing Address - Fax:
Practice Address - Street 1:5500 S MARGINAL RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-1072
Practice Address - Country:US
Practice Address - Phone:216-221-7588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker