MEDICARE: CATHERINE VERTALKA LPC, CAADC, ACS

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	101Y00000X	Counselor	6401012709	MI

General Provider Information

NPI Number	:	1235494303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE VERTALKA LPC, CAADC, ACS

Provider Business Mailing Address
First Line	:	3635 SCHOLAR LN
Second Line	:
City	:	HOLT
State	:	MI
Zip	:	48842-9417
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1750 E GRAND RIVER AVE STE 101
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-4958
Country	:	US
Telephone Number	:	616-745-4045
Fax Number	:

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

Provider Enumeration Date	:	07/05/2012
Last Update Date	:	09/18/2025

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