Provider Demographics
NPI:1457916173
Name:JENNIFER KATES, LMSW LLC
Entity Type:Organization
Organization Name:JENNIFER KATES, LMSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:KATES
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:616-994-2663
Mailing Address - Street 1:36 W 8TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-2702
Mailing Address - Country:US
Mailing Address - Phone:616-994-2663
Mailing Address - Fax:866-212-5601
Practice Address - Street 1:36 W 8TH ST STE 200
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-2702
Practice Address - Country:US
Practice Address - Phone:616-994-2663
Practice Address - Fax:866-212-5601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health