Provider Demographics
NPI:1467689968
Name:KAREN E VEDRODY INC
Entity Type:Organization
Organization Name:KAREN E VEDRODY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:VEDRODY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:810-732-9451
Mailing Address - Street 1:4481 LENNON RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1064
Mailing Address - Country:US
Mailing Address - Phone:810-732-9451
Mailing Address - Fax:810-732-1002
Practice Address - Street 1:4481 LENNON RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1064
Practice Address - Country:US
Practice Address - Phone:810-732-9451
Practice Address - Fax:810-732-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801018399101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI08922791802Medicare PIN