Individual
JOHN ANTHONY KRECEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA,CAADC, MATS, CCJP
Contact information
Practice address
4218 W WESTERN AVE, SOUTH BEND, IN 46619-2622
(574) 233-1524
Mailing address
12173 SPRUCE ST, SAWYER, MI 49125-9155
(269) 985-3151
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
32436
IL
101YA0400X
Addiction (Substance Use Disorder) Counselor
CCJP-1005
IN
101YA0400X
Addiction (Substance Use Disorder) Counselor
MATS-148
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
IN
05
—
0
—
MI
Enumeration date
02/18/2015
Last updated
06/26/2015
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