Healthcare Provider Details

I. General information

NPI: 1689124679
Provider Name (Legal Business Name): MARY KURTIS KAUFIELD MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY SCHULTZ

II. Dates (important events)

Enumeration Date: 10/13/2016
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 SUMMIT DR
WATERFORD MI
48328-3364
US

IV. Provider business mailing address

6052 JADA DR
HIGHLAND MI
48356-2079
US

V. Phone/Fax

Practice location:
  • Phone: 248-599-8999
  • Fax:
Mailing address:
  • Phone: 248-285-2364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401001466
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133002278
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: