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NPI Code Detail

MEDICARE: KELLEY MICHEL RAAB-BUTLER LMSW

MEDICARE:   KELLEY MICHEL RAAB-BUTLER  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
11041C0700XClinical Social Worker6801087904MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
214229139OTHERMICAQH

General Provider Information

NPI Number : 1649360769
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLEY MICHEL RAAB-BUTLER LMSW
Provider Business Mailing Address
First Line : 207 N FRANKLIN ST
Second Line :
City : MOUNT PLEASANT
State : MI
Zip : 48858-2303
Country : US
Telephone Number : 231-580-9585
Fax Number : 989-546-8550
Provider Business Practice Location Address
First Line : 207 N FRANKLIN ST
Second Line :
City : MOUNT PLEASANT
State : MI
Zip : 48858-2303
Country : US
Telephone Number : 989-824-2374
Fax Number : 989-546-8550
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2006
Last Update Date : 06/07/2023

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Directions to “ KELLEY MICHEL RAAB-BUTLER LMSW” Practice Location

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