Provider Demographics
NPI:1811353824
Name:GASEVSKI, KATARINA (LPC)
Entity type:Individual
Prefix:
First Name:KATARINA
Middle Name:
Last Name:GASEVSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KATARINA
Other - Middle Name:
Other - Last Name:ILIOSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:7455 COLCHESTER LN
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3189
Mailing Address - Country:US
Mailing Address - Phone:248-765-5040
Mailing Address - Fax:
Practice Address - Street 1:7455 COLCHESTER LN
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3189
Practice Address - Country:US
Practice Address - Phone:248-765-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008279101YP2500X
MI0000259101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool