Provider Demographics
NPI:1417167065
Name:JAGER, KATHLEEN BURNS (PHD, LMFT, LLP)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:BURNS
Last Name:JAGER
Suffix:
Gender:F
Credentials:PHD, LMFT, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:482 ANHINGA DR
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-8662
Mailing Address - Country:US
Mailing Address - Phone:517-719-8715
Mailing Address - Fax:
Practice Address - Street 1:908 E MOUNT HOPE AVE
Practice Address - Street 2:PERSPECTIVES THERAPY SERVICES
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-3262
Practice Address - Country:US
Practice Address - Phone:517-719-8715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301010528103TF0000X
MI4101006266106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily