Healthcare Provider Details

I. General information

NPI: 1730588765
Provider Name (Legal Business Name): KATHERINE LOVELL LMSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE REEBER LMSW-C

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49396 CHESHIRE LN
CANTON MI
48187-1262
US

IV. Provider business mailing address

44515 ERIK PASS
PLYMOUTH MI
48170-3975
US

V. Phone/Fax

Practice location:
  • Phone: 734-512-7122
  • Fax:
Mailing address:
  • Phone: 734-512-7122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801110923
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: