Healthcare Provider Details

I. General information

NPI: 1750115002
Provider Name (Legal Business Name): MADISON KUHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2024
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 TURNER ST STE A
LANSING MI
48906-4373
US

IV. Provider business mailing address

1900 CROMWELL ST
HOLT MI
48842-1578
US

V. Phone/Fax

Practice location:
  • Phone: 517-574-4197
  • Fax: 517-484-1771
Mailing address:
  • Phone: 517-420-3206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: