Individual
KAYLEEN DEPUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CCS, CADC, LBSW
Contact information
Practice address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8282
Mailing address
3351 CLAYSTONE ST SE STE 212, GRAND RAPIDS, MI 49546-5781
(616) 965-8282
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401014423
MI
1041C0700X
Clinical Social Worker
6802085626
MI
146M00000X
Intermediate Emergency Medical Technician
3202002671
MI
Other
Enumeration date
03/29/2012
Last updated
03/22/2022
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