MEDICARE: KATI LANE LOISELLE LMSW

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	1041C0700X	Clinical Social Worker	6801101040	MI

General Provider Information

NPI Number	:	1265063077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATI LANE LOISELLE LMSW

Provider Business Mailing Address
First Line	:	301 NEBOBISH AVE
Second Line	:
City	:	ESSEXVILLE
State	:	MI
Zip	:	48732-1158
Country	:	US
Telephone Number	:	989-992-1997
Fax Number	:

Provider Business Practice Location Address
First Line	:	509 CENTER AVE STE 100
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-5974
Country	:	US
Telephone Number	:	989-249-3227
Fax Number	:

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

Provider Enumeration Date	:	01/30/2020
Last Update Date	:	11/05/2025

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Directions to “ KATI LANE LOISELLE LMSW” Practice Location

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