Provider Demographics
NPI:1730745852
Name:KLS COUNSELING LLC
Entity type:Organization
Organization Name:KLS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALERNO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LLP
Authorized Official - Phone:616-299-7184
Mailing Address - Street 1:688 CASCADE WEST PKWY SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2171
Mailing Address - Country:US
Mailing Address - Phone:616-299-7184
Mailing Address - Fax:
Practice Address - Street 1:688 CASCADE WEST PKWY SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2171
Practice Address - Country:US
Practice Address - Phone:616-299-7184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty