Healthcare Provider Details

I. General information

NPI: 1902110224
Provider Name (Legal Business Name): KATHRYN HELEN CATELLIER LMSW, IMH-E( II )
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2010
Last Update Date: 07/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2387 E WALTON BLVD
AUBURN HILLS MI
48326-1955
US

IV. Provider business mailing address

267 HENDRICKSON BLVD
CLAWSON MI
48017-1691
US

V. Phone/Fax

Practice location:
  • Phone: 248-475-6300
  • Fax:
Mailing address:
  • Phone: 248-585-6597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801018755
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: