Provider Demographics
NPI:1265266498
Name:KP & ASSOCIATES, LLC.
Entity type:Organization
Organization Name:KP & ASSOCIATES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:KERBY
Authorized Official - Middle Name:
Authorized Official - Last Name:KILLINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:616-856-0037
Mailing Address - Street 1:3940 PENINSULAR DR SE STE 230
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-6187
Mailing Address - Country:US
Mailing Address - Phone:616-856-0037
Mailing Address - Fax:616-699-4750
Practice Address - Street 1:3940 PENINSULAR DR SE STE 230
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-6187
Practice Address - Country:US
Practice Address - Phone:616-856-0037
Practice Address - Fax:616-699-4750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health