Kimberly Green

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Richmond, MI

NPI 1770080038 · NPPES record last updated Apr 12, 2018

Key facts

NPI
1770080038
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
400 Stoddard Rd
Richmond, MI 48062-2505
Phone
(810) 392-2167
Fax
(810) 392-8103
NPI assigned
Apr 12, 2018
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

400 Stoddard Rd
Richmond, MI 48062-2505

Mailing address

2011 8TH St
Port Huron, MI 48060-6327
Phone (810) 488-2961

Other providers in Richmond, MI

All providers in Richmond, MI · Addiction (Substance Use Disorder) Counselor in Michigan

Sources for this page

Verify at the official NPI Registry.