Provider Demographics
NPI:1063539633
Name:HOWELL, MICHELLE KRISTEN (LCSW 26189)
Entity type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:KRISTEN
Last Name:HOWELL
Suffix:
Gender:F
Credentials:LCSW 26189
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:HOWELL
Other - Last Name:HOWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:925 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-4372
Mailing Address - Country:US
Mailing Address - Phone:559-216-1075
Mailing Address - Fax:
Practice Address - Street 1:1925 E DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-4821
Practice Address - Country:US
Practice Address - Phone:559-216-1075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA26189101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA10410000XOtherNPI
CA10410000XOtherLCSW
CALCSW1041C0700XOtherLCSW26189
CALCSW1041C0700XOtherLCWS 26189