Provider Demographics
NPI:1831219104
Name:KREUTZBERG, ALAN JOHN (ACSW MSW LMSW)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:JOHN
Last Name:KREUTZBERG
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Gender:M
Credentials:ACSW MSW LMSW
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Mailing Address - Street 1:5031 PARK LAKE ROAD
Mailing Address - Street 2:MERIDIAN PROFESSIONAL PSYCHOLOGICAL CONSULTANTS PC
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823
Mailing Address - Country:US
Mailing Address - Phone:517-332-0811
Mailing Address - Fax:517-332-4452
Practice Address - Street 1:5031 PARK LAKE ROAD
Practice Address - Street 2:MERIDIAN PROFESSIONAL PSYCHOLOGICAL CONSULTANTS PC
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823
Practice Address - Country:US
Practice Address - Phone:517-332-0811
Practice Address - Fax:517-332-4452
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MI68010128451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical