Individual
MRS. CAROL ANN KENISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LLP, LPC
Contact information
Practice address
130 N MAIN ST, LAKE CITY, MI 49651-5103
(231) 295-1196
Mailing address
602 S WILSON AVE, ROYAL OAK, MI 48067-2950
(248) 867-2499
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401008847
MI
101YP2500X
Professional Counselor
6401008847
MI
103TC0700X
Clinical Psychologist
6301013036
MI
Other
Enumeration date
10/20/2009
Last updated
07/22/2025
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