Provider Demographics
NPI:1346819885
Name:RICE, KATHRYN (LMSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:KREBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10852 PINE VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49401-9641
Mailing Address - Country:US
Mailing Address - Phone:586-980-9716
Mailing Address - Fax:
Practice Address - Street 1:890 WASHINGTON AVE STE 150
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-7702
Practice Address - Country:US
Practice Address - Phone:616-952-9957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-20
Last Update Date:2021-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010933641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical