Provider Demographics
NPI:1750781878
Name:BUBLITZ, KAITLYN SHIELDS (LPC)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:SHIELDS
Last Name:BUBLITZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:
Other - Last Name:SHEILDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:8116 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:HARBOR SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49740-9571
Mailing Address - Country:US
Mailing Address - Phone:810-287-9275
Mailing Address - Fax:
Practice Address - Street 1:8116 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:HARBOR SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49740-9571
Practice Address - Country:US
Practice Address - Phone:810-287-9275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014427101YM0800X, 101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor