Provider Demographics
NPI:1699502252
Name:GARCIA, KATELYNN MARIE (MA LLPC)
Entity type:Individual
Prefix:MRS
First Name:KATELYNN
Middle Name:MARIE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MA LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 KENT ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MI
Mailing Address - Zip Code:48611-9470
Mailing Address - Country:US
Mailing Address - Phone:989-891-6829
Mailing Address - Fax:
Practice Address - Street 1:2460 BURTON ST SE STE 101
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-4800
Practice Address - Country:US
Practice Address - Phone:616-309-0737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451023907APP24101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health