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General NPI Number Information
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NPI Number | 1467911024
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Entity Type | Individual
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Provider Name | KAITLYNN RAYE MORELLI LPC
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Gender | Female
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 03/13/2019
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Provider Practice Location Address
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Address Line | 15300 21 MILE RD
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City | MACOMB
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State | MI
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Zip | 48044-5024
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Country | US
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Telephone | 810-599-5866
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Fax |
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Provider Business Mailing Address
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Address Line | 45073 ELMHURST CT
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48317-4986
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Country | US
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Telephone | 810-599-5866
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401015480
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License Number State | MI
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