Provider Demographics
NPI:1962109371
Name:SUMMERHILL, KERRIE
Entity type:Individual
Prefix:
First Name:KERRIE
Middle Name:
Last Name:SUMMERHILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13560 76TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49090-9483
Mailing Address - Country:US
Mailing Address - Phone:269-202-6059
Mailing Address - Fax:
Practice Address - Street 1:13560 76TH ST STE 3
Practice Address - Street 2:
Practice Address - City:SOUTH HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49090-9483
Practice Address - Country:US
Practice Address - Phone:269-202-6059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical