MEDICARE: KEVIN HAROLD NEUMAN LMSW, CAADC

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	6801087849	MI

General Provider Information

NPI Number	:	1407930175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN HAROLD NEUMAN LMSW, CAADC

Provider Business Mailing Address
First Line	:	8355 TYLER ST
Second Line	:
City	:	ZEELAND
State	:	MI
Zip	:	49464-9574
Country	:	US
Telephone Number	:	616-635-3158
Fax Number	:

Provider Business Practice Location Address
First Line	:	1231 E BELTLINE AVE NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-4501
Country	:	US
Telephone Number	:	616-464-8118
Fax Number	:

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	01/11/2012

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