| Kiyoi Craig Lmsw Llc | |
|
5890 Kalamazoo Ave Se Kentwood MI 49508-6416 | |
| (616) 813-2605 | |
| Not Available |
| Full Name | Kiyoi Craig Lmsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 5890 Kalamazoo Ave Se, Kentwood, Michigan |
| Authorized Official Name and Position | Kiyoi J Craig (LMSW-CLINICAL THERAPIST) |
| Authorized Official Contact | 6162811803 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kiyoi Craig Lmsw Llc 5890 Kalamazoo Ave Se Kentwood MI 49508-6416 Ph: (616) 813-2605 | Kiyoi Craig Lmsw Llc 5890 Kalamazoo Ave Se Kentwood MI 49508-6416 Ph: (616) 813-2605 |
| NPI Number | 1881129716 |
|---|---|
| Provider Enumeration Date | 04/28/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 6507136546 |
|---|---|
| Medicare Enrollment ID | O20170724002589 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881129716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 6801092618 (Michigan) | Primary |
| Provider Name | Kiyoi J Craig |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588963474 PECOS PAC ID: 1052581444 Enrollment ID: I20110822000323 |
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