Healthcare Provider Details

I. General information

NPI: 1831652213
Provider Name (Legal Business Name): KURTIS OAKLEE MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 W 9 MILE RD STE 210
FERNDALE MI
48220-1750
US

IV. Provider business mailing address

195 W 9 MILE RD STE 210
FERNDALE MI
48220-1750
US

V. Phone/Fax

Practice location:
  • Phone: 248-291-7464
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number53274
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4101007678
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: