Provider Demographics
NPI:1992938351
Name:HAGADONE, KATE MILLER (MA, PHD, LP)
Entity type:Individual
Prefix:DR
First Name:KATE
Middle Name:MILLER
Last Name:HAGADONE
Suffix:
Gender:F
Credentials:MA, PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 LOUISE DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2858
Mailing Address - Country:US
Mailing Address - Phone:269-598-4332
Mailing Address - Fax:
Practice Address - Street 1:333 MAYNARD ST
Practice Address - Street 2:STE 402
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2282
Practice Address - Country:US
Practice Address - Phone:269-598-4332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2020-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MI6301015349103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health