Basic Information
| Provider Information | |||||||||
| NPI: | 1598164857 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KRING | ||||||||
| FirstName: | DESIREA | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2460 WALENJUS CT | ||||||||
| Address2: | |||||||||
| City: | HOLT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488429703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5179742448 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3960 PATIENT CARE DR STE 101 | ||||||||
| Address2: | |||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489114276 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5178823732 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2014 | ||||||||
| LastUpdateDate: | 06/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 6801096281 | MI | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.