Healthcare Provider Details

I. General information

NPI: 1649046145
Provider Name (Legal Business Name): KAITLIN MICHELLE VENS LMSW- MI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9171 LAPEER ROAD SUITE 500
DAVISON MI
48423
US

IV. Provider business mailing address

9171 LAPEER ROAD SUITE 500
DAVISON MI
48423
US

V. Phone/Fax

Practice location:
  • Phone: 810-214-1750
  • Fax: 810-214-1753
Mailing address:
  • Phone: 810-214-1750
  • Fax: 810-214-1753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801117402
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: