Provider Demographics
NPI:1881971695
Name:SLAVIN, KARRIE DAWN POLLENS (MSW, MPH, LMSW)
Entity type:Individual
Prefix:MRS
First Name:KARRIE
Middle Name:DAWN POLLENS
Last Name:SLAVIN
Suffix:
Gender:F
Credentials:MSW, MPH, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 CLAYSTONE ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7738
Mailing Address - Country:US
Mailing Address - Phone:616-949-7460
Mailing Address - Fax:
Practice Address - Street 1:3330 CLAYSTONE ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7738
Practice Address - Country:US
Practice Address - Phone:616-949-7460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010987621041C0700X
NCC0083681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical