Provider Demographics
NPI:1801260252
Name:KESSLER, KIMBERLEY SUE (LLMSW)
Entity type:Individual
Prefix:MS
First Name:KIMBERLEY
Middle Name:SUE
Last Name:KESSLER
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:MS
Other - First Name:KIMBERLEY
Other - Middle Name:SUE
Other - Last Name:LUCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:14799 DIX-TOLEDO ROAD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-2507
Mailing Address - Country:US
Mailing Address - Phone:734-324-8326
Mailing Address - Fax:734-324-8327
Practice Address - Street 1:14799 DIX TOLEDO RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2507
Practice Address - Country:US
Practice Address - Phone:734-324-8326
Practice Address - Fax:734-324-8327
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-23
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI18012602521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical