Healthcare Provider Details

I. General information

NPI: 1659067601
Provider Name (Legal Business Name): CARLEE RENEE KREMSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 RIVERSIDE AVE
ADRIAN MI
49221-1476
US

IV. Provider business mailing address

770 RIVERSIDE AVE
ADRIAN MI
49221-1476
US

V. Phone/Fax

Practice location:
  • Phone: 517-264-2244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: