Doctor Name: | MS. KELLY R TATE |
NPI Number: | 1326203100 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED, LPC |
License Number: | 6401006355 |
Business Practice Address: | 880 W Long Lake Rd Suite 600 Troy, MI - 480984504 |
Business Phone Number: | 2489251790 |
Business Fax Number: | |
Mailing Address: | 880 W Long Lake Rd, Suite 600 TROY |
State: | MI |
Postal Code: | 480984504 |
Phone Number: | 2489251790 |
Fax Number: | |
NPI Enumeration Date: | 07/22/2008 |
NPI Last Update Date: | 10/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 6401006355 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |