Provider Demographics
NPI:1417846502
Name:NAUTA, KRISTEN BETH (LMSW)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:BETH
Last Name:NAUTA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:BETH
Other - Last Name:WOLFFIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:430 E 8TH ST STE 246
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-3751
Mailing Address - Country:US
Mailing Address - Phone:616-209-8539
Mailing Address - Fax:616-828-0293
Practice Address - Street 1:27 W 25TH ST
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-4910
Practice Address - Country:US
Practice Address - Phone:616-209-8539
Practice Address - Fax:616-828-0293
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041S0200X
MI68010793001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool