Provider Demographics
NPI:1841293230
Name:EMANS, KATHY JOY (MSW)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:JOY
Last Name:EMANS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60640 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:DOWAGIAC
Mailing Address - State:MI
Mailing Address - Zip Code:49047-9711
Mailing Address - Country:US
Mailing Address - Phone:574-220-3453
Mailing Address - Fax:
Practice Address - Street 1:960 E. STATE
Practice Address - Street 2:
Practice Address - City:CASSOPOLIS
Practice Address - State:MI
Practice Address - Zip Code:49031
Practice Address - Country:US
Practice Address - Phone:269-445-2451
Practice Address - Fax:269-445-3216
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010359271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical