Shaeles Marie Goretzka, LMSW
Social Worker, Clinical in Kalamazoo, MI. Individual provider (NPI-1).
NPI number1124530688
StatusActive
Last updated in NPPESJul 5, 2023
Details
- NPI
- 1124530688
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Shaeles Marie Goretzka
- Credential
- LMSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 24, 2017
- Certification date
- Jul 5, 2023
- Last updated
- Jul 5, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 6801097263 | MI | Yes |
Other names
- Shae Goretzka (Other Name)
Practice location
1608 Lake StKalamazoo, MI 49001-3170
Phone 269-270-2367 · Fax 269-344-0285
Mailing address
5212 Torrey Pines DrKalamazoo, MI 49009-3839
Phone 269-352-0082
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