Organization
LAURIE B. KIMMEL, LMSW, ACSW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE KIMMEL LMSW (CLINICAL SOCIAL WORKER)
(248) 660-4637
Entity
Organization
Contact information
Practice address
5596 FOX HUNT LN, WEST BLOOMFIELD, MI 48322-1639
(248) 660-4637
(636) 582-5957
Mailing address
5596 FOX HUNT LN, WEST BLOOMFIELD, MI 48322-1639
(248) 660-4637
(636) 582-5957
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6801057192
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP1240
MEDICARE CA
MI
Enumeration date
02/01/2013
Last updated
02/01/2013
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