| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MICHELLE KIDWELL | 1710638200 | 2022-01-16 |
Michelle Kidwell is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1710638200. Registration indicates Michelle Kidwell is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Mental Health, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Mental Health, Behavioral Health & Social Service Providers) (Counselor, )
| Entity Type | Individual |
| Provider Name | Michelle Kidwell |
| Practice Office Address | 11362 COUNTRY CLUB RD LAWRENCEVILLE, IL US |
| Practice Office Telephone | 6189433302 |
| Practice Office Fax | 6189433657 |
| Mailing Address | 11362 COUNTRY CLUB RD LAWRENCEVILLE, IL 624394325 US |
| Business Telephone | 6189433302 |
| Business Fax | 6189433657 |
| email [] | [email protected] |
| Code | Practice | License No State |
|---|---|---|
| 101YM0800X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Mental Health Behavioral Health/Substance Abuse/Psychiatry Counselor Mental Health Behavioral Health & Social Service Providers Counselor |