Provider Demographics
NPI:1366280489
Name:LUTEY-FALKEY, KATELYN (MA, LPC)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:LUTEY-FALKEY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 HAMILL RD
Mailing Address - Street 2:
Mailing Address - City:OTISVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48463-9612
Mailing Address - Country:US
Mailing Address - Phone:248-884-4438
Mailing Address - Fax:
Practice Address - Street 1:9600 HAMILL RD
Practice Address - Street 2:
Practice Address - City:OTISVILLE
Practice Address - State:MI
Practice Address - Zip Code:48463-9612
Practice Address - Country:US
Practice Address - Phone:248-884-4438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401018074101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional