MEDICARE: ANNA-LIISA MARIE KAUTZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	6451024833	MI

General Provider Information

NPI Number	:	1174159586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA-LIISA MARIE KAUTZ

Provider Business Mailing Address
First Line	:	308 CLEVELAND AVE STE 114
Second Line	:
City	:	ISHPEMING
State	:	MI
Zip	:	49849-1842
Country	:	US
Telephone Number	:	906-631-7507
Fax Number	:

Provider Business Practice Location Address
First Line	:	308 CLEVELAND AVE STE 114
Second Line	:
City	:	ISHPEMING
State	:	MI
Zip	:	49849-1842
Country	:	US
Telephone Number	:	906-631-7507
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2020
Last Update Date	:	02/04/2026

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