Healthcare Provider Details

I. General information

NPI: 1053136093
Provider Name (Legal Business Name): CATHERINE ANN WOODHOUSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 HOGBACK RD STE 17
ANN ARBOR MI
48105-9736
US

IV. Provider business mailing address

4007 CARPENTER RD # 214
YPSILANTI MI
48197-9644
US

V. Phone/Fax

Practice location:
  • Phone: 734-956-0051
  • Fax: 888-976-6019
Mailing address:
  • Phone: 734-956-0051
  • Fax: 888-976-6019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451025023
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2406215-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: