Provider Demographics
NPI:1407930175
Name:NEUMAN, KEVIN HAROLD (LMSW, CAADC)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:HAROLD
Last Name:NEUMAN
Suffix:
Gender:M
Credentials:LMSW, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8355 TYLER ST
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-9574
Mailing Address - Country:US
Mailing Address - Phone:616-635-3158
Mailing Address - Fax:
Practice Address - Street 1:1231 E BELTLINE AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-4501
Practice Address - Country:US
Practice Address - Phone:616-464-8118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010878491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical