Healthcare Provider Details

I. General information

NPI: 1346175684
Provider Name (Legal Business Name): CAITLYN ROSE WETHERBEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

38271 MOUND RD
STERLING HEIGHTS MI
48310-3401
US

IV. Provider business mailing address

1812 MCLAIN AVE
LINCOLN PARK MI
48146-2204
US

V. Phone/Fax

Practice location:
  • Phone: 586-303-2255
  • Fax:
Mailing address:
  • Phone: 313-808-0256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: