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Organization
KELLY A GROCOFF LLC
Active
Organization
KELLY A GROCOFF LLC
Active
Other names
Casselman Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY GROCOFF LMSW (OWNER)
(734) 272-5813
Entity
Organization
Contact information
Practice address
122 S MAIN ST STE 360A, ANN ARBOR, MI 48104-1932
(734) 926-5366
Mailing address
122 S MAIN ST STE 360A, ANN ARBOR, MI 48104-1932
(734) 926-5366
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P140669
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
Enumeration date
03/25/2020
Last updated
05/05/2020
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