Provider Demographics
NPI:1336493915
Name:RICH, CATHERINE LOUISE (MA, LLPC, NCC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LOUISE
Last Name:RICH
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 1:136 170TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-1358
Mailing Address - Country:US
Mailing Address - Phone:616-610-0959
Mailing Address - Fax:
Practice Address - Street 1:12048 JAMES ST
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-9661
Practice Address - Country:US
Practice Address - Phone:616-396-3391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-03
Last Update Date:2012-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
268868101Y00000X
MI6401012858101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor