Provider Demographics
NPI:1386784817
Name:AUGUST, KATHIE (MA LLPC NCC)
Entity type:Individual
Prefix:
First Name:KATHIE
Middle Name:
Last Name:AUGUST
Suffix:
Gender:F
Credentials:MA LLPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24255 W 13 MILE RD STE 280
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4322
Mailing Address - Country:US
Mailing Address - Phone:248-505-1032
Mailing Address - Fax:248-723-3901
Practice Address - Street 1:24255 W 13 MILE RD STE 280
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4322
Practice Address - Country:US
Practice Address - Phone:248-505-1032
Practice Address - Fax:248-723-3901
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010106101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health