Provider Demographics
NPI:1134412505
Name:NEEL, MICHELLE LYNN (LPC, NCC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:NEEL
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1387 E M 89
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MI
Mailing Address - Zip Code:49078-9301
Mailing Address - Country:US
Mailing Address - Phone:269-692-2100
Mailing Address - Fax:269-692-2101
Practice Address - Street 1:1387 E M 89
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MI
Practice Address - Zip Code:49078-9301
Practice Address - Country:US
Practice Address - Phone:269-692-2100
Practice Address - Fax:269-692-2101
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009981101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor