Provider Demographics
NPI:1508212697
Name:GIACONA, ARLENE (LMSW)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:
Last Name:GIACONA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:
Other - Last Name:KEMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:5320 HOLIDAY TER STE 3
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-2100
Mailing Address - Country:US
Mailing Address - Phone:269-599-0976
Mailing Address - Fax:
Practice Address - Street 1:5380 HOLIDAY TER STE 32
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-2128
Practice Address - Country:US
Practice Address - Phone:269-459-1512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010959861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical