Healthcare Provider Details

I. General information

NPI: 1487788014
Provider Name (Legal Business Name): KIMBERLY ARMSTRONG MBA, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 S MAIN ST SUITE 6
PLYMOUTH MI
48170-1778
US

IV. Provider business mailing address

9259 SILVERSIDE
SOUTH LYON MI
48178-9316
US

V. Phone/Fax

Practice location:
  • Phone: 734-451-7800
  • Fax: 734-451-5410
Mailing address:
  • Phone: 734-451-7800
  • Fax: 734-451-5410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6802082254
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: