MEDICARE: MARY KLYM ACSW,LMSW

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	101Y00000X	Counselor	6801035403	MI

General Provider Information

NPI Number	:	1285822270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY KLYM ACSW,LMSW

Provider Business Mailing Address
First Line	:	9577 E WALKABOUT LN
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-6862
Country	:	US
Telephone Number	:	231-935-6911
Fax Number	:	231-935-6920

Provider Business Practice Location Address
First Line	:	1105 SIXTH ST
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-2345
Country	:	US
Telephone Number	:	231-935-6911
Fax Number	:	231-935-6920

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2007
Last Update Date	:	12/14/2025

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