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General NPI Number Information
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NPI Number | 1205488624
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Entity Type | Individual
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Provider Name | ANDRE R KEMP LLMSW
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Gender | Male
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Dates
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Enumeration Date | 07/16/2019
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 3400 S WASHINGTON RD
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City | SAGINAW
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State | MI
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Zip | 48601-4958
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Country | US
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Telephone | 989-755-1072
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Fax |
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Provider Business Mailing Address
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Address Line | 1013 N RIVER RD
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City | SAGINAW
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State | MI
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Zip | 48609-6833
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Country | US
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Telephone | 989-755-1072
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 6801105006
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6851105006
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License Number State | MI
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