Healthcare Provider Details

I. General information

NPI: 1609225069
Provider Name (Legal Business Name): MRS. KRISTIN OWEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN HESSLING LMSW, CAADC, QMHP

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 02/22/2024
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 COLUMBUS AVE MCLAREN BAY REGION
BAY CITY MI
48708
US

IV. Provider business mailing address

1900 COLUMBUS AVE MCLAREN BAY REGION
BAY CITY MI
48708
US

V. Phone/Fax

Practice location:
  • Phone: 989-894-3000
  • Fax:
Mailing address:
  • Phone: 989-894-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6801099583
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801099583
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801104204
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: