Provider Demographics
NPI:1548884638
Name:PIEVSKY, MICHELLE (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:PIEVSKY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:ARKOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:57 WINDWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-2100
Mailing Address - Country:US
Mailing Address - Phone:917-517-6764
Mailing Address - Fax:
Practice Address - Street 1:1527 ROUTE 12
Practice Address - Street 2:
Practice Address - City:GALES FERRY
Practice Address - State:CT
Practice Address - Zip Code:06335-1800
Practice Address - Country:US
Practice Address - Phone:860-464-7248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS02072103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist