Provider Demographics
NPI:1649610940
Name:KULHANEK, KEVIN M (LLMSW)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:M
Last Name:KULHANEK
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11184 PRIMROSE WAY
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48094-1571
Mailing Address - Country:US
Mailing Address - Phone:586-337-5996
Mailing Address - Fax:
Practice Address - Street 1:11184 PRIMROSE WAY
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MI
Practice Address - Zip Code:48094-1571
Practice Address - Country:US
Practice Address - Phone:586-337-5996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801095520104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker