Provider Demographics
NPI:1356647283
Name:KEUHS, ADELE N (LMSW)
Entity Type:Individual
Prefix:MS
First Name:ADELE
Middle Name:N
Last Name:KEUHS
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 1:550 CHERRY ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4748
Mailing Address - Country:US
Mailing Address - Phone:616-235-7272
Mailing Address - Fax:
Practice Address - Street 1:550 CHERRY ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4748
Practice Address - Country:US
Practice Address - Phone:616-235-7272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-10
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801076868104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker