Provider Demographics
NPI:1306037551
Name:MANSON, KELLY KRISTINE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:KRISTINE
Last Name:MANSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:KELLY
Other - Middle Name:KRISTINE
Other - Last Name:FRANKOWSKI-HARRISON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:22849 SHERRY DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48134-9064
Mailing Address - Country:US
Mailing Address - Phone:734-552-0992
Mailing Address - Fax:
Practice Address - Street 1:6405 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-2036
Practice Address - Country:US
Practice Address - Phone:734-344-0069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010893951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical