Provider Demographics
NPI:1922017631
Name:STEINMAN, KATHLYN MARIE (MSW LMSW ACSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLYN
Middle Name:MARIE
Last Name:STEINMAN
Suffix:
Gender:F
Credentials:MSW LMSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:789 N CLARE AVE
Mailing Address - Street 2:P.O. BOX 817
Mailing Address - City:HARRISON
Mailing Address - State:MI
Mailing Address - Zip Code:48625-9194
Mailing Address - Country:US
Mailing Address - Phone:989-539-2141
Mailing Address - Fax:989-539-2143
Practice Address - Street 1:789 N CLARE AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:MI
Practice Address - Zip Code:48625-9194
Practice Address - Country:US
Practice Address - Phone:989-539-2141
Practice Address - Fax:989-539-2143
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010657511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI305193OtherMHN
MI8008970770OtherBLUE CROSS BLUE SHIELD
MI0N75820Medicare ID - Type Unspecified