Individual
MS. CARLEEN ANNA KORMOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLMSW
Contact information
Practice address
324 LYON ST NE, GRAND RAPIDS, MI 49503-5607
(616) 451-2039
(616) 451-3590
Mailing address
324 LYON ST NE, GRAND RAPIDS, MI 49503-5607
(616) 451-2039
(616) 451-3590
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6801092795
MI
1041C0700X
Clinical Social Worker
Primary
6801092795
MI
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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