Provider Demographics
NPI:1275805756
Name:STRATTON, KIMBERLY DAWN (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:DAWN
Last Name:STRATTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 E BELTLINE AVE NE STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-1214
Mailing Address - Country:US
Mailing Address - Phone:616-805-3660
Mailing Address - Fax:616-805-3631
Practice Address - Street 1:360 E BELTLINE AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-1214
Practice Address - Country:US
Practice Address - Phone:616-805-3660
Practice Address - Fax:616-805-3631
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010881371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical