Provider Demographics
NPI:1659787919
Name:VORA, KRUPA (LLMSW)
Entity Type:Individual
Prefix:
First Name:KRUPA
Middle Name:
Last Name:VORA
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3524 HERON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-4520
Mailing Address - Country:US
Mailing Address - Phone:248-342-2107
Mailing Address - Fax:
Practice Address - Street 1:4413 CORUNNA RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-4321
Practice Address - Country:US
Practice Address - Phone:810-733-5735
Practice Address - Fax:810-733-5733
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-08
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802088235171M00000X
MI6801105692101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty