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KIM MICHELLE CHILDRESS
NPI 1124410808
Counselor - Professional in Kentwood, MI

Active since March 04, 2015
3300 36TH ST SE, KENTWOOD, MI 49512(616) 304-7517 Get Directions Write a Review

NPPES record last updated: June 5, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 5, 2024, Oct 17, 2018, Jul 31, 2018 (3 updates tracked since 2018).

About Kim Michelle Childress NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIM MICHELLE CHILDRESS (NPI 1124410808) is an individual professional provider in Kentwood, Michigan, licensed in Michigan (6451015430) and active in the NPI registry since March 2015. She maintains a secondary practice location in Grandville.

NPPES Registry Identity

NPI1124410808
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKIM MICHELLE CHILDRESS
Location Address3300 36TH ST SEKentwood, MI 49512-2810
Mailing Address3300 36th St SeKentwood, MI 49512-2810 · (616) 304-7517 · Fax (616) 245-0450
Phone(616) 304-7517
Sole ProprietorYes
Enumeration DateMarch 4, 2015
Last NPPES UpdateJune 5, 20243 updates tracked since enumeration
NPPES CertifiedJune 5, 2024
✔ NPI 1124410808 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MI · 6451015430
3300 36TH ST SE, Kentwood, MI 49512
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Other Names 1

Former Name (1)Kim Broome Childress

Secondary Practice Location 1

Location 13181 Prairie St SW Ste 104Grandville, MI 49418-2076 · Phone (616) 304-7517

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KATHERINE E. KUNNEN DNP, FNP-C, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
3300 36TH ST SE
GRAND RAPIDS, MI 49512
Kent County (616) 942-2110
MEGAN ELINOR JOHNSON BCBA
Behavior Analyst
3300 36TH ST SE
GRAND RAPIDS, MI 49512
Kent County (616) 942-2810
MALINNA I MACK
Behavior Technician
3300 36TH ST SE
GRAND RAPIDS, MI 49512
Kent County (616) 942-2110
ALEIGHA DROUGHN
Behavior Analyst
3300 36TH ST SE
GRAND RAPIDS, MI 49512
Kent County (616) 942-2110
MATTHEW JOHN MANNIKKO
Behavior Technician
3300 36TH ST SE
GRAND RAPIDS, MI 49512
Kent County (616) 942-2110
CLARISSA LEE GREER
Behavior Technician
3300 36TH ST SE
GRAND RAPIDS, MI 49512
Kent County (616) 942-2110
MARGARET GRACE GILLICH
Behavior Technician
3300 36TH ST SE
GRAND RAPIDS, MI 49512
Kent County (616) 942-2110
CATHERINE ROSE KUIPERS RN
Student in an Organized Health Care Education/Training Program
3300 36TH ST SE
GRAND RAPIDS, MI 49512
Kent County (616) 942-2110

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kim Childress's NPI number?

The NPI number for Kim Childress is 1124410808. It was assigned to this individual provider in the NPPES registry on March 4, 2015. The provider is also known as Kim Broome Childress.

Where is Kim Childress located?

Kim Childress practices at 3300 36th St SE, Kentwood, MI 49512. The listed phone number is (616) 304-7517.

What is Kim Childress's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Kim Childress was last updated on June 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.