Provider Demographics
NPI:1205111325
Name:HOWARD, MICHELLE RENEE (MSW)
Entity type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:RENEE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 5TH ST
Mailing Address - Street 2:
Mailing Address - City:RISING SUN
Mailing Address - State:IN
Mailing Address - Zip Code:47040-9489
Mailing Address - Country:US
Mailing Address - Phone:812-537-7375
Mailing Address - Fax:812-537-5271
Practice Address - Street 1:427 W EADS PKWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-1139
Practice Address - Country:US
Practice Address - Phone:812-537-7375
Practice Address - Fax:812-537-5271
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IN34006897A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health