Provider Demographics
NPI:1982904132
Name:KRANENDONK, SHELDON (MA, LLPC, CAAC, IMH)
Entity Type:Individual
Prefix:MR
First Name:SHELDON
Middle Name:
Last Name:KRANENDONK
Suffix:
Gender:M
Credentials:MA, LLPC, CAAC, IMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 506
Mailing Address - Street 2:
Mailing Address - City:PICKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49774-0506
Mailing Address - Country:US
Mailing Address - Phone:906-647-2217
Mailing Address - Fax:
Practice Address - Street 1:416 N M 129
Practice Address - Street 2:
Practice Address - City:PICKFORD
Practice Address - State:MI
Practice Address - Zip Code:49774-9204
Practice Address - Country:US
Practice Address - Phone:906-647-2217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-21
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011522101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health