Healthcare Provider Details

I. General information

NPI: 1316734783
Provider Name (Legal Business Name): KAYLEE KRUSE MIND-BODY THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 ASHLEY AVE NE
BELDING MI
48809-9621
US

IV. Provider business mailing address

4701 ASHLEY AVE NE
BELDING MI
48809-9621
US

V. Phone/Fax

Practice location:
  • Phone: 989-751-4123
  • Fax:
Mailing address:
  • Phone: 989-751-4123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KAYLEE MARIE KRUSE
Title or Position: PSYCHOTHERAPIST
Credential: LMSQ
Phone: 989-751-4123