Healthcare Provider Details
I. General information
NPI: 1033090170
Provider Name (Legal Business Name): CATHOLIC CHARITIES OF INGHAM, EATON AND CLINTON COUNTIES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2800 W WILLOW ST
LANSING MI
48917-1833
US
IV. Provider business mailing address
2800 W WILLOW ST
LANSING MI
48917-1833
US
V. Phone/Fax
- Phone: 517-323-4734
- Fax:
- Phone: 517-323-4734
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HALIE
PLATTE
Title or Position: CHILDREN'S HOME DIRECTOR
Credential:
Phone: 517-282-7853