Individual provider Active NPI

Allyson Leverich, LCSW, PH.D

  • Clinical Social Worker
  • Charlevoix, MI
National Provider Identifier
1194942953
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1005 May St
Charlevoix, MI 49720-9380
Phone
(906) 450-7207
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1005 May St
Charlevoix, MI 49720-9380

Mailing address

12441 Meanderline Rd
Charlevoix, MI 49720-1072
Phone (906) 450-7207

Other practice location 1

321 Lake St
Manistique, MI 49854-1407
Phone (906) 450-7207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090728000236 MI Practitioner - Clinical Social Worker 9032262803 Practice locations: Charlevoix, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1005 May St
Charlevoix, MI 49720-9380
Phone (906) 450-7207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Mirrored Waters Counseling Clinical CurrentSince Oct 9, 2022 Accepting new patients

Locations

1005 May St
Charlevoix, MI 49720
Phone (231) 758-6182

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1194942953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12441 MEANDERLINE RD",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201072",
            "telephone_number": "906-450-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MAY ST",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497209380",
            "telephone_number": "906-450-7207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 Lake St",
            "address_purpose": "LOCATION",
            "city": "Manistique",
            "state": "MI",
            "postal_code": "498541407",
            "country_code": "US",
            "telephone_number": "906-450-7207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVERICH",
        "first_name": "ALLYSON",
        "credential": "LCSW, PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlevoix, MI

Sources for this page

Verify at the official NPI Registry.