Healthcare Provider Details

I. General information

NPI: 1457134918
Provider Name (Legal Business Name): KATHERYN KARAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CASCADE WEST PKWY SE STE 240
GRAND RAPIDS MI
49546-2166
US

IV. Provider business mailing address

3358 BYRON CENTER AVE SW APT 112
WYOMING MI
49519-3295
US

V. Phone/Fax

Practice location:
  • Phone: 616-591-9000
  • Fax: 616-591-9060
Mailing address:
  • Phone: 734-353-3585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851121524
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number6851121524
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: