Katie Fennell is a Clinical in Grand Rapids, Michigan. Katie Fennell practices all healthcare services and medical treatments related to Clinical. The NPI Number for Katie Fennell is 1023164670. The last update date is 2015-06-22.
Katie Fennell's current location address is 2340 Dean Lake Ave Ne, Grand Rapids, Michigan. You can contact this provider via phone number 6163616014 and fax number 6163618051. The mailing address for Katie Fennell is 2340 Dean Lake Ave Ne, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Katie Fennell |
|---|---|
| Address | 2340 Dean Lake Ave Ne, Grand Rapids, Michigan |
| Phone Number | 6163616014 |
| Fax Number | 6163618051 |
| Sole Proprietor | Y |
| Credentials | LMSW |
NPI Number Detail
| NPI Number | 1023164670 |
|---|---|
| Provider Enumeration Date | 2007-01-26 |
| Last Updated Date | 2015-06-22 |
Provider Mailing Address Detail
| Address | 2340 Dean Lake Ave Ne |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495054446 |
| Phone Number | 6163616014 |
| Fax Number | 6163618051 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 6801090673 |
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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 10-digit identification code issued to Katie Fennell by the Centers for Medicare & Medicaid Services?
The Katie Fennell has been assigned the NPI (National Provider Identifier) 1023164670 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete physical location address of Katie Fennell?
The Katie Fennell is physically situated at 2340 Dean Lake Ave Ne, in the city of Grand Rapids, state of MI, with the postal code 495054446.
What is the Katie Fennell's specialty and taxonomy code?
The Katie Fennell's specialty is Clinical, and the corresponding taxonomy code is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1023164670 to Katie Fennell?
The Centers for Medicare & Medicaid Services assigned the 1023164670 to Katie Fennell on 2007-01-26.
When was the information regarding Katie Fennell most recently updated?
The details pertaining to the Katie Fennell, including its address, specialty, and other relevant information, were last refreshed on 2015-06-22.
NPI Number: 1982607784
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