Healthcare Provider Details

I. General information

NPI: 1013085984
Provider Name (Legal Business Name): KATHLEEN ANN ALLIN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22900 REMICK DR
CLINTON TWP MI
48036-2732
US

IV. Provider business mailing address

24735 GLOUCHESTER ST APT 311
HARRISON TWP MI
48045-3154
US

V. Phone/Fax

Practice location:
  • Phone: 586-783-4802
  • Fax: 586-783-4805
Mailing address:
  • Phone: 586-746-1161
  • Fax: 586-783-4805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801089292
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: