Provider Demographics
NPI:1215523436
Name:GOEBEL, KATHARINA MARIA (MA, LLPC)
Entity type:Individual
Prefix:
First Name:KATHARINA
Middle Name:MARIA
Last Name:GOEBEL
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:GOEBEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LLPC
Mailing Address - Street 1:382 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-3150
Mailing Address - Country:US
Mailing Address - Phone:313-618-5541
Mailing Address - Fax:
Practice Address - Street 1:23231 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1361
Practice Address - Country:US
Practice Address - Phone:248-581-8777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-13
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451018843101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health