Healthcare Provider Details

I. General information

NPI: 1942686431
Provider Name (Legal Business Name): HEATHER BRIEGEL-MCCORD LMSW, CAADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2015
Last Update Date: 10/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 HOWARD ST
KALAMAZOO MI
49001-2748
US

IV. Provider business mailing address

401 HOWARD ST
KALAMAZOO MI
49001-2748
US

V. Phone/Fax

Practice location:
  • Phone: 269-344-4458
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801098500
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: