Healthcare Provider Details

I. General information

NPI: 1063572691
Provider Name (Legal Business Name): MAUREEN MCNAMARA LMSW DCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAUREEN KILKELLY

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 W MANCHESTER ST
BATTLE CREEK MI
49017-3016
US

IV. Provider business mailing address

1520 TEXEL DR
KALAMAZOO MI
49048-1327
US

V. Phone/Fax

Practice location:
  • Phone: 269-660-3905
  • Fax: 269-660-3899
Mailing address:
  • Phone: 269-660-3905
  • Fax: 269-660-3899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801034386
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: