Kenneth John Nydam in Cadillac - Clinical
Kenneth John Nydam - NPI 1194990614
Kenneth John Nydam is a Clinical in Cadillac, Michigan. Kenneth John Nydam practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kenneth John Nydam is 1194990614. The last update date is 2013-01-22.
Kenneth John Nydam's current location address is 5839 Hope Way, Cadillac, Michigan. You can contact this provider via phone number 2319428455. The mailing address for Kenneth John Nydam is 5839 Hope Way, Cadillac, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth John Nydam |
|---|---|
| Address | 5839 Hope Way, Cadillac, Michigan |
| Phone Number | 2319428455 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LMSW |
NPI Number Detail
| NPI Number | 1194990614 |
|---|---|
| Provider Enumeration Date | 2008-04-25 |
| Last Updated Date | 2013-01-22 |
Provider Mailing Address Detail
| Address | 5839 Hope Way |
|---|---|
| City | Cadillac |
| State | Michigan (MI) |
| Post Code | 496017085 |
| Phone Number | 2319428455 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique identifier code issued to Kenneth John Nydam by the Centers for Medicare & Medicaid Services (CMS)?
The Kenneth John Nydam has been assigned the NPI (National Provider Identifier) 1194990614. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the Kenneth John Nydam located?
The Kenneth John Nydam is located at 5839 Hope Way, Cadillac, MI 496017085.
What is Kenneth John Nydam's area of expertise and its corresponding taxonomy classification?
The Kenneth John Nydam's field of specialization is Clinical, and it falls under the taxonomy code 1041C0700X, which categorizes healthcare providers based on their areas of practice.
On what date was the 1194990614 assigned to Kenneth John Nydam?
The Kenneth John Nydam was issued its 1194990614 on 2008-04-25, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Kenneth John Nydam's details last updated?
The information pertaining to the Kenneth John Nydam, including its address, specialty, and other details, was most recently updated on 2013-01-22.
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