Provider Demographics
NPI:1174791453
Name:KACIN, JENNIFER ARREMONY (BA/ LLBSW)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ARREMONY
Last Name:KACIN
Suffix:
Gender:F
Credentials:BA/ LLBSW
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:DENISE
Other - Last Name:ARREMONY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:21885 DUNHAM RD
Mailing Address - Street 2:STE. 1
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-1030
Mailing Address - Country:US
Mailing Address - Phone:586-469-6502
Mailing Address - Fax:586-469-6637
Practice Address - Street 1:21885 DUNHAM RD
Practice Address - Street 2:STE. 1
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-1030
Practice Address - Country:US
Practice Address - Phone:586-469-6502
Practice Address - Fax:586-469-6637
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802085716104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker