Basic Information
| Provider Information | |||||||||
| NPI: | 1326632985 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAIN | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | |||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4851 E PICKARD ST STE 1760 | ||||||||
| Address2: | |||||||||
| City: | MT PLEASANT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488582038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897751610 | ||||||||
| FaxNumber: | 9897751640 | ||||||||
| Practice Location | |||||||||
| Address1: | 4851 E PICKARD ST STE 1760 | ||||||||
| Address2: | |||||||||
| City: | MT PLEASANT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488582038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897751610 | ||||||||
| FaxNumber: | 9897751640 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2021 | ||||||||
| LastUpdateDate: | 02/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 6801106041 | MI | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.