Doctor Name: | MR. KENNETH L RICHMOND |
NPI Number: | 1245341940 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.M.S.W. |
License Number: | 6801064001 |
Business Practice Address: | 1049 E Newell St Box 867 White Cloud, MI - 493498795 |
Business Phone Number: | 2316897330 |
Business Fax Number: | 2316897345 |
Mailing Address: | 1389 Indian Lakes Rd Ne, SPARTA |
State: | MI |
Postal Code: | 493459504 |
Phone Number: | 2316897330 |
Fax Number: | 2316897345 |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801064001 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |