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NPI Code Detail

MEDICARE: AMY KISEL MA LLPC, CAADC

MEDICARE: AMY KISEL MA LLPC, CAADC
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
1101Y00000XCounselor6401011784MI

General Provider Information

NPI Number : 1770941734
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY KISEL MA LLPC, CAADC
Provider Business Mailing Address
First Line : 2800 S SHEPHERD RD
Second Line :
City : MOUNT PLEASANT
State : MI
Zip : 48858-8966
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2800 S SHEPHERD RD
Second Line :
City : MOUNT PLEASANT
State : MI
Zip : 48858-8966
Country : US
Telephone Number : 989-775-4850
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2016
Last Update Date : 02/05/2016

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