Provider Demographics
NPI:1447977467
Name:KAIROS COUNSELING AND WELLNESS
Entity type:Organization
Organization Name:KAIROS COUNSELING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LMSW
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:DANGC
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-449-4162
Mailing Address - Street 1:1774 E ROUND LAKE RD
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820-8403
Mailing Address - Country:US
Mailing Address - Phone:517-449-4162
Mailing Address - Fax:
Practice Address - Street 1:12800 ESCANABA DR STE D
Practice Address - Street 2:
Practice Address - City:DEWITT
Practice Address - State:MI
Practice Address - Zip Code:48820-8680
Practice Address - Country:US
Practice Address - Phone:517-449-4162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-20
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty