Kathleen Cooley, LMSW, LCSW

Individual provider Active NPI Clinical Social Worker · Mesick, MI

NPI 1215554696 · NPPES record last updated Jul 1, 2020

Key facts

NPI
1215554696
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
6801033979 (MI)
Practice address
581 S. Clark Street
Mesick, MI 49668
Phone
(231) 885-1200
NPI assigned
Jul 1, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6801033979MIMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801033979 MI Yes

Addresses

Primary practice location

581 S. Clark Street
Mesick, MI 49668

Mailing address

2076 W 16 Rd
Mesick, MI 49668

Other providers in Mesick, MI

All providers in Mesick, MI · Clinical Social Worker in Michigan

Sources for this page

Verify at the official NPI Registry.