Provider Demographics
NPI:1720400641
Name:GAMBY, CATHY LYNN (MA, LLPC)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:LYNN
Last Name:GAMBY
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17973 BRUCKER ST
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-9334
Mailing Address - Country:US
Mailing Address - Phone:616-402-0026
Mailing Address - Fax:
Practice Address - Street 1:234 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-1357
Practice Address - Country:US
Practice Address - Phone:616-402-0026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-12
Last Update Date:2014-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008035101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor