Provider Demographics
NPI:1053110270
Name:KIRKSEY, AMBER (LMSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:KIRKSEY
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10581 PAPIN RD
Mailing Address - Street 2:
Mailing Address - City:PELKIE
Mailing Address - State:MI
Mailing Address - Zip Code:49958-9638
Mailing Address - Country:US
Mailing Address - Phone:906-201-1148
Mailing Address - Fax:
Practice Address - Street 1:10581 PAPIN RD
Practice Address - Street 2:
Practice Address - City:PELKIE
Practice Address - State:MI
Practice Address - Zip Code:49958-9638
Practice Address - Country:US
Practice Address - Phone:906-201-1148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011094601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical