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Organization
GREAT LAKES COMPREHENSIVE PSYCHOLOGICAL SERVICES
Active
Organization
GREAT LAKES COMPREHENSIVE PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARHTA CATHERINE KELLEY CSW (OWNER)
(517) 783-4418
Entity
Organization
Contact information
Practice address
1200 N WEST AVE STE 812, JACKSON, MI 49202-2180
(517) 783-4418
(517) 783-4504
Mailing address
1200 N WEST AVE STE 812, JACKSON, MI 49202-2180
(517) 783-4418
(517) 783-4504
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
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