Healthcare Provider Details

I. General information

NPI: 1033758131
Provider Name (Legal Business Name): MICHAEL F. KESSLER LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2020
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 S CREYTS RD
LANSING MI
48917-8289
US

IV. Provider business mailing address

1001 FAIRWAY LN APT 6
LANSING MI
48912-5054
US

V. Phone/Fax

Practice location:
  • Phone: 517-319-5818
  • Fax:
Mailing address:
  • Phone: 517-204-1604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801046551
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: