Kimberly Ann Cardeccia, MA, LPC
Individual provider Active NPI Professional Counselor · Fenton, MI
NPI 1376057729 · NPPES record last updated Nov 21, 2017
Key facts
- NPI
- 1376057729
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 6401007923 (MI)
- Practice address
- 7601 E Allen Rd
Fenton, MI 48430-9221 - Phone
- (517) 898-5094
- NPI assigned
- Nov 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401007923 | MI | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401007923 | MI | Yes |
Addresses
Primary practice location
7601 E Allen Rd
Fenton, MI 48430-9221
Mailing address
3840 Listerman Rd
Howell, MI 48855-9741
Phone (517) 898-5094
Other providers in Fenton, MI
- Cafe of Life Fenton, LLC
- Lyndsay Caldwell
- Paul Douglas Callan
- Callard Chiropractic, P.C.
- James Michael Callard
- Samantha Cardenas
- James Carlo
- Janice Carol
- Mark Carpenter
- Deborah Carter
All providers in Fenton, MI · Professional Counselor in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.