Individual
MR. KENNETH SHINE HEUVELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, CAADC, CCS
Contact information
Practice address
520 SUPERIOR ST, PORT HURON, MI 48060-3838
(810) 984-4202
Mailing address
3479 MINNIE DR, LAKEPORT, MI 48059-1948
(810) 637-1123
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
BBH-LAC-LIC-24075
MT
101YA0400X
Addiction (Substance Use Disorder) Counselor
C-03596
MI
101YM0800X
Mental Health Counselor
Primary
6401225382
MI
101YM0800X
Mental Health Counselor
6451022467
MI
Other
Enumeration date
09/11/2017
Last updated
08/04/2025
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