Provider Demographics
NPI:1861518771
Name:DOAN, KATHLEEN MICHELLE (MA LPC NCC)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MICHELLE
Last Name:DOAN
Suffix:
Gender:F
Credentials:MA LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 PLATE ST UNIT 202
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1661
Mailing Address - Country:US
Mailing Address - Phone:248-601-4421
Mailing Address - Fax:
Practice Address - Street 1:6637 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-1675
Practice Address - Country:US
Practice Address - Phone:248-666-8870
Practice Address - Fax:248-666-5023
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008588101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor