Provider Demographics
NPI:1033274261
Name:GRABOWSKI, CATHRYN M (MA, LPC)
Entity Type:Individual
Prefix:
First Name:CATHRYN
Middle Name:M
Last Name:GRABOWSKI
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 1:400 W MAIN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-1886
Mailing Address - Country:US
Mailing Address - Phone:231-233-8972
Mailing Address - Fax:
Practice Address - Street 1:400 W MAIN ST STE 205
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1886
Practice Address - Country:US
Practice Address - Phone:231-233-8972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007336101YA0400X, 101YM0800X
MI64010007336101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1712452Medicaid
MI20378Medicare UPIN
MI20351Medicare UPIN
MI1712452Medicaid
MI750910482Medicare UPIN
MI750910902Medicare UPIN
MI20366Medicare UPIN
MI20386Medicare UPIN
MI750910903Medicare UPIN
MI750910904Medicare UPIN
MIOP22320Medicare ID - Type Unspecified