MEDICARE: KEITH FOISY CLINICAL SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1104776046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEITH FOISY CLINICAL SERVICES PLLC

Provider Business Mailing Address
First Line	:	6515 34TH AVE
Second Line	:
City	:	HUDSONVILLE
State	:	MI
Zip	:	49426-9071
Country	:	US
Telephone Number	:	616-389-0708
Fax Number	:

Provider Business Practice Location Address
First Line	:	6515 34TH AVE
Second Line	:
City	:	HUDSONVILLE
State	:	MI
Zip	:	49426-9071
Country	:	US
Telephone Number	:	616-389-0708
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	KEITH J FOISY
Credential	:	LLMSW
Telephone Number	:	616-389-0708

Provider Enumeration Date	:	01/30/2026
Last Update Date	:	01/30/2026

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