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General NPI Number Information
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NPI Number | 1760021356
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Entity Type | Individual
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Provider Name | KELLY NICKOLE FISHER-SATTERFIELD LLMSW
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Gender | Female
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Dates
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Enumeration Date | 12/30/2019
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 5990 VENTURE PARK DR
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City | KALAMAZOO
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State | MI
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Zip | 49009-1858
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Country | US
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Telephone | 616-301-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 6 ENLOW CT
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City | BATTLE CREEK
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State | MI
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Zip | 49015-4636
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Country | US
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Telephone | 219-363-9479
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801101618
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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 | 6801101618
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License Number State | MI
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