Provider Demographics
NPI:1265063077
Name:LOISELLE, KATI LANE (LMSW)
Entity type:Individual
Prefix:
First Name:KATI
Middle Name:LANE
Last Name:LOISELLE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 NEBOBISH AVE
Mailing Address - Street 2:
Mailing Address - City:ESSEXVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48732-1158
Mailing Address - Country:US
Mailing Address - Phone:989-992-1997
Mailing Address - Fax:
Practice Address - Street 1:509 CENTER AVE STE 100
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-5974
Practice Address - Country:US
Practice Address - Phone:989-249-3227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011010401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty