Healthcare Provider Details

I. General information

NPI: 1902725104
Provider Name (Legal Business Name): KENNETH DAVID FIELD MSWLL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 W WASHINGTON ST STE 106
MARQUETTE MI
49855-4350
US

IV. Provider business mailing address

102 W WASHINGTON ST STE 106
MARQUETTE MI
49855-4350
US

V. Phone/Fax

Practice location:
  • Phone: 906-228-8881
  • Fax: 906-228-4549
Mailing address:
  • Phone: 906-228-8881
  • Fax: 906-228-4549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851122566
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: