Provider Demographics
NPI:1437789468
Name:WHIPPLE-MULDOON, KATHLEEN MARGARET (MS, LMFT, CAADC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MARGARET
Last Name:WHIPPLE-MULDOON
Suffix:
Gender:F
Credentials:MS, LMFT, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 N OLD WOODWARD AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-3341
Mailing Address - Country:US
Mailing Address - Phone:248-218-9436
Mailing Address - Fax:
Practice Address - Street 1:36400 WOODWARD AVE STE 202
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-0913
Practice Address - Country:US
Practice Address - Phone:248-218-9436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-17
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIC-03943101YA0400X
CA117145106H00000X
MI4101006996106H00000X
MI6301018388103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical