Provider Demographics
NPI:1376888966
Name:KIRACOFE, LOVE LE (LMSW)
Entity Type:Individual
Prefix:
First Name:LOVE
Middle Name:LE
Last Name:KIRACOFE
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 1:03070 48 1/2 ST
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:MI
Mailing Address - Zip Code:49056-9785
Mailing Address - Country:US
Mailing Address - Phone:269-330-9727
Mailing Address - Fax:
Practice Address - Street 1:1410 TURWILL LN
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-1931
Practice Address - Country:US
Practice Address - Phone:269-327-7472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010882791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical