Healthcare Provider Details

I. General information

NPI: 1215477716
Provider Name (Legal Business Name): JENNIFER AILEEN KREFT LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2017
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 MICHIGAN ST NE STE B
GRAND RAPIDS MI
49506-1266
US

IV. Provider business mailing address

430 N FOSTER AVE
LANSING MI
48912-4108
US

V. Phone/Fax

Practice location:
  • Phone: 517-930-4442
  • Fax:
Mailing address:
  • Phone: 517-930-4442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801097362
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: