Provider Demographics
NPI:1922100791
Name:GUTE, KATHERINE MCGARVEY (MSW, LCSW, ACSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MCGARVEY
Last Name:GUTE
Suffix:
Gender:F
Credentials:MSW, LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 TIMBERCREEK DR
Mailing Address - Street 2:
Mailing Address - City:GRAND LEDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48837-2322
Mailing Address - Country:US
Mailing Address - Phone:517-622-4448
Mailing Address - Fax:
Practice Address - Street 1:311 HARRISON ST
Practice Address - Street 2:
Practice Address - City:GRAND LEDGE
Practice Address - State:MI
Practice Address - Zip Code:48837-1577
Practice Address - Country:US
Practice Address - Phone:517-927-3382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010604691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMIS 242635000OtherMAGELLAN ID
MI99943OtherBLUE CARE NETWORK ID
8008925560OtherBLUE CROSS/BLUE SHIELD ID
8008925560OtherBLUE CROSS/BLUE SHIELD ID