Kelly J Kubiak, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801084320 Issued in MI

Practice address

655 E Cedar Ave
Gladwin, MI 48624-2215

Phone

(989) 426-9295

Fax

(989) 426-2251

NPI assigned

Jul 28, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• List Psychological Services, PLC

  • Clinical Social Worker
  • Sandusky, MI
  • NPI 1174267116
  NPD (past)
• Tuscola County Community Mental Health Services Board

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Caro, MI
  • NPI 1275644775
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073527685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 E CEDAR AVE",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486242215",
            "telephone_number": "989-426-9295",
            "fax_number": "989-426-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 E CEDAR AVE",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486242215",
            "telephone_number": "989-426-9295",
            "fax_number": "989-426-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIAK",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801084320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Kozlow
• Eric Kreckman
• Pheonix Lacoe Kreutzer-Bailey, PK
• Megan Lee Krueger
• Ronald J Kruske, DDS
• Hayley May Lademann
• Grace Katherine Lang
• Kayei L Lang
• Renee Michele Lang, PTA
• Martha Louise Lapointe, LBSW

• Clinical Social Worker in Gladwin, MI
• Providers in Gladwin, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.