Provider Demographics
NPI:1699170506
Name:KIEKINTVELD, BARBARA JEAN (LPC)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JEAN
Last Name:KIEKINTVELD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 W LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-1325
Mailing Address - Country:US
Mailing Address - Phone:616-610-0753
Mailing Address - Fax:
Practice Address - Street 1:1121 OTTAWA BEACH RD
Practice Address - Street 2:SUITE 240
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-2528
Practice Address - Country:US
Practice Address - Phone:616-610-0753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006353101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional