Provider Demographics
NPI:1437373552
Name:KINSTLE, RITA (MA, LLPC, CAC-M)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:
Last Name:KINSTLE
Suffix:
Gender:F
Credentials:MA, LLPC, CAC-M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31153 PLYMOUTH RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-2134
Mailing Address - Country:US
Mailing Address - Phone:734-474-8131
Mailing Address - Fax:
Practice Address - Street 1:31153 PLYMOUTH RD
Practice Address - Street 2:SUITE 104
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-2134
Practice Address - Country:US
Practice Address - Phone:734-474-8131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-04117101YA0400X
MI6401012582101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health