Healthcare Provider Details

I. General information

NPI: 1982006987
Provider Name (Legal Business Name): CATHERINE ZATKOFF MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2014
Last Update Date: 09/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23409 JEFFERSON AVE STE 104
SAINT CLAIR SHORES MI
48080-3449
US

IV. Provider business mailing address

23232 CLAIRWOOD ST
SAINT CLAIR SHORES MI
48080-3414
US

V. Phone/Fax

Practice location:
  • Phone: 586-382-7306
  • Fax:
Mailing address:
  • Phone: 586-296-0634
  • Fax: 586-296-0634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401007062
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: