Healthcare Provider Details

I. General information

NPI: 1235494303
Provider Name (Legal Business Name): CATHERINE VERTALKA LPC, CAADC, ACS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 E GRAND RIVER AVE STE 101
EAST LANSING MI
48823-4958
US

IV. Provider business mailing address

3635 SCHOLAR LN
HOLT MI
48842-9417
US

V. Phone/Fax

Practice location:
  • Phone: 616-745-4045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401012709
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: