Healthcare Provider Details

I. General information

NPI: 1427869478
Provider Name (Legal Business Name): KRYSTLE KATHLEEN WRIGHT-LOVELESS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2025
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 STODDARD RD
RICHMOND MI
48062-2505
US

IV. Provider business mailing address

5586 LAPEER RD APT 5C
KIMBALL MI
48074-1320
US

V. Phone/Fax

Practice location:
  • Phone: 810-392-2167
  • Fax:
Mailing address:
  • Phone: 810-858-0880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: