Provider Demographics
NPI:1841931375
Name:CLIMIE, KELLEY (LLMSW)
Entity type:Individual
Prefix:
First Name:KELLEY
Middle Name:
Last Name:CLIMIE
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3415
Mailing Address - Country:US
Mailing Address - Phone:616-288-4908
Mailing Address - Fax:855-320-3424
Practice Address - Street 1:72 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3415
Practice Address - Country:US
Practice Address - Phone:616-288-4908
Practice Address - Fax:855-320-3424
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011048911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical