Provider Demographics
NPI:1548438914
Name:WASHBURN, MICHELLE E (LPC)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:E
Last Name:WASHBURN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9525 KATY FWY STE 312
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1467
Mailing Address - Country:US
Mailing Address - Phone:832-498-1015
Mailing Address - Fax:
Practice Address - Street 1:9525 KATY FWY STE 312
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1467
Practice Address - Country:US
Practice Address - Phone:832-498-1015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62261101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional