Provider Demographics
NPI:1477665719
Name:HOUCK, NANCY BETH (LMSW CSW)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:BETH
Last Name:HOUCK
Suffix:
Gender:F
Credentials:LMSW CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019 RAMBLING ROAD
Mailing Address - Street 2:DESERT STREAMS CHRISTIAN COUNSELING
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008
Mailing Address - Country:US
Mailing Address - Phone:269-345-0909
Mailing Address - Fax:269-345-4985
Practice Address - Street 1:2019 RAMBLING ROAD
Practice Address - Street 2:DESERT STREAMS CHRISTIAN COUNSELING
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008
Practice Address - Country:US
Practice Address - Phone:269-345-0909
Practice Address - Fax:269-345-4985
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801018893104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOC96111Medicare ID - Type Unspecified