Healthcare Provider Details

I. General information

NPI: 1336815331
Provider Name (Legal Business Name): CATHOLIC FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 01/12/2022
Certification Date: 01/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 S WESTNEDGE AVE
KALAMAZOO MI
49008-1370
US

IV. Provider business mailing address

1819 GULL RD
KALAMAZOO MI
49048-1611
US

V. Phone/Fax

Practice location:
  • Phone: 269-381-1234
  • Fax: 268-381-9809
Mailing address:
  • Phone: 269-381-9800
  • Fax: 269-381-2932

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 Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: TONI NEWELL
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 269-381-9800