Basic Information
| Provider Information | |||||||||
| NPI: | 1043765803 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KONE | ||||||||
| FirstName: | MOHAMED | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.S.W., L.L.M.S.W | ||||||||
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| Mailing Information | |||||||||
| Address1: | 46329 WESTMINISTER DR | ||||||||
| Address2: | |||||||||
| City: | MACOMB | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480443391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2487098471 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1102 MACKIN RD | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485031204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102573709 | ||||||||
| FaxNumber: | 8102573755 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2016 | ||||||||
| LastUpdateDate: | 08/22/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801099839 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.