Healthcare Provider Details

I. General information

NPI: 1962260166
Provider Name (Legal Business Name): KAYLA KREUTZER COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 03/12/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 KERRY ST STE 210
LANSING MI
48912-3671
US

IV. Provider business mailing address

2510 KERRY ST STE 210
LANSING MI
48912-3671
US

V. Phone/Fax

Practice location:
  • Phone: 630-297-5838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KAYLA KREUTZER
Title or Position: LICENSED MASTER SOCIAL WORKER
Credential:
Phone: 630-297-5838