Provider Demographics
NPI:1669245015
Name:KATHRYN GLEASON MA LMFT PLLC
Entity type:Organization
Organization Name:KATHRYN GLEASON MA LMFT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GLEASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-935-2165
Mailing Address - Street 1:8440 PINE COVE DR
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-4452
Mailing Address - Country:US
Mailing Address - Phone:248-935-2165
Mailing Address - Fax:
Practice Address - Street 1:31330 NORTHWESTERN HWY STE A
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2560
Practice Address - Country:US
Practice Address - Phone:248-935-2165
Practice Address - Fax:877-552-0793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty