Provider Demographics
NPI:1407920432
Name:KENEL, KERRI MICHELLE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KERRI
Middle Name:MICHELLE
Last Name:KENEL
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 1:5305 W RIVER DR NE
Mailing Address - Street 2:
Mailing Address - City:COMSTOCK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:49321-8527
Mailing Address - Country:US
Mailing Address - Phone:616-644-4550
Mailing Address - Fax:
Practice Address - Street 1:134 E. EDGERTON ST.
Practice Address - Street 2:
Practice Address - City:HOWARD CITY
Practice Address - State:MI
Practice Address - Zip Code:49329
Practice Address - Country:US
Practice Address - Phone:231-937-9959
Practice Address - Fax:231-937-4361
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010782301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical