Healthcare Provider Details

I. General information

NPI: 1396658373
Provider Name (Legal Business Name): KAITLYN MICHELLE LAWLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAITLYN MICHELLE SZMATULA

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 S LAPEER RD STE B
OXFORD MI
48371-6511
US

IV. Provider business mailing address

16377 GLENFIELD DR
MACOMB MI
48044-3212
US

V. Phone/Fax

Practice location:
  • Phone: 248-891-2255
  • Fax:
Mailing address:
  • Phone: 586-876-3785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451025421
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: