Provider Demographics
NPI:1477431138
Name:KITTLESON MSW THERAPY PLLC
Entity type:Organization
Organization Name:KITTLESON MSW THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:
Authorized Official - Last Name:KITTLESON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:734-489-9893
Mailing Address - Street 1:1131 N OSSEO RD
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-9714
Mailing Address - Country:US
Mailing Address - Phone:517-523-3695
Mailing Address - Fax:
Practice Address - Street 1:1010 S GRINNELL ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-2945
Practice Address - Country:US
Practice Address - Phone:734-489-9893
Practice Address - Fax:517-523-3311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty