Kathy Varboncoeur, CADC, SST

Primary specialty

SpecialistTaxonomy code 174400000X

License

2-00422 Issued in MI

Practice address

1823 Commerce St
Muskegon, MI 49441-2608

Phone

(231) 728-2138

Fax

(231) 722-4771

NPI assigned

Oct 2, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Kathy Lyn Kittle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1669875779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18724 ELLENWOOD LN",
            "city": "FRUITPORT",
            "state": "MI",
            "postal_code": "494159541",
            "telephone_number": "231-740-9621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1823 COMMERCE ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494412608",
            "telephone_number": "231-728-2138",
            "fax_number": "231-722-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARBONCOEUR",
        "first_name": "KATHY",
        "name_prefix": "Ms.",
        "credential": "CADC, SST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-02",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "6803058152",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "2-00422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "KITTLE",
            "middle_name": "LYN",
            "prefix": "MRS.",
            "credential": "CADC, SST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Edward Vanlente, LCSW
• Emilee Vanlinden, LLMSW
• Austin Vanree, PA-C
• Sarah Elaine Vansolkema, BSW
• David A Vanwinkle, MD
• Shannon Varela
• Elizabeth Kuzala Vargo, PT, OTR, CHT
• Michael J Vargo
• Amy B Varnado, MSW
• Byron L Varnado, MD

• Specialist in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.