Provider Demographics
NPI:1427949601
Name:WOODY, MICHELLE (EDD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:WOODY
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BERACAH WALK SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-8514
Mailing Address - Country:US
Mailing Address - Phone:310-923-6824
Mailing Address - Fax:
Practice Address - Street 1:105 BERACAH WALK SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-8514
Practice Address - Country:US
Practice Address - Phone:310-923-6824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015150101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional