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General NPI Number Information
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NPI Number | 1083583835
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Entity Type | Organization
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Legal Business Name | KIM OHEARN LLC
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Dates
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Enumeration Date | 10/31/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 4301 CANAL AVE SW STE C
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City | GRANDVILLE
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State | MI
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Zip | 49418-2667
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Country | US
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Telephone | 269-876-2202
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Fax |
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Provider Business Mailing Address
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Address Line | 2521 ALMAR ST
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City | JENISON
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State | MI
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Zip | 49428-9108
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Country | US
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Telephone | 269-876-2202
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | KIMBERLY OHEARN
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Credential | LMSW
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Telephone | 269-876-2202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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