Provider Demographics
NPI:1538995717
Name:KEMP, BEN
Entity type:Individual
Prefix:
First Name:BEN
Middle Name:
Last Name:KEMP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 GRANADA DR APT 2B
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-5228
Mailing Address - Country:US
Mailing Address - Phone:517-745-9038
Mailing Address - Fax:
Practice Address - Street 1:212 E BIDDLE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-1800
Practice Address - Country:US
Practice Address - Phone:517-745-9038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker