| Katherine Lister Lmsw Pllc | |
|
255 Seminole Rd Ste 205 Norton Shores MI 49444-3758 | |
| (616) 808-7262 | |
| (844) 647-9797 |
| Full Name | Katherine Lister Lmsw Pllc |
|---|---|
| Speciality | Counselor |
| Location | 255 Seminole Rd Ste 205, Norton Shores, Michigan |
| Authorized Official Name and Position | Katherine Lister (MANAGER) |
| Authorized Official Contact | 6168087262 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katherine Lister Lmsw Pllc 901 W Fennwood Cir Muskegon MI 49445-2484 Ph: (616) 808-7262 | Katherine Lister Lmsw Pllc 255 Seminole Rd Ste 205 Norton Shores MI 49444-3758 Ph: (616) 808-7262 |
| NPI Number | 1205402880 |
|---|---|
| Provider Enumeration Date | 06/03/2021 |
| Last Update Date | 06/03/2021 |
| Certification Date | 06/03/2021 |
| Medicare PECOS PAC ID | 4486014156 |
|---|---|
| Medicare Enrollment ID | O20230713002573 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205402880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Katherine A Lister |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821319666 PECOS PAC ID: 6204006216 Enrollment ID: I20110831000197 |
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