MEDICARE: ANGELA M KURTZ LPC, CAADC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	6401013617	MI

General Provider Information

NPI Number	:	1336583384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA M KURTZ LPC, CAADC, NCC

Provider Business Mailing Address
First Line	:	113 4TH ST
Second Line	:	P.O. BOX 217
City	:	ALPHA
State	:	MI
Zip	:	49902
Country	:	US
Telephone Number	:	906-284-3420
Fax Number	:	906-265-2004

Provider Business Practice Location Address
First Line	:	1305 PROSPECT AVE
Second Line	:
City	:	IRON MOUNTAIN
State	:	MI
Zip	:	49801-4624
Country	:	US
Telephone Number	:	906-282-5081
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2013
Last Update Date	:	09/23/2024

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