Provider Demographics
NPI:1144716788
Name:SARGENT, MICHELLE (LMFT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:SARGENT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12450 MAGNOLIA BLVD UNIT 4333
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91617-7021
Mailing Address - Country:US
Mailing Address - Phone:323-543-5809
Mailing Address - Fax:323-676-2032
Practice Address - Street 1:16311 VENTURA BLVD STE 810
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4374
Practice Address - Country:US
Practice Address - Phone:323-543-5809
Practice Address - Fax:323-676-2032
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA106609106H00000X
CA120455106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist