Provider Demographics
NPI:1710252291
Name:KLEAR, MICHELLE LOUISE (MS LLPC)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LOUISE
Last Name:KLEAR
Suffix:
Gender:F
Credentials:MS LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 ARDMORE ST SE STE 202A
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-4901
Mailing Address - Country:US
Mailing Address - Phone:586-201-5350
Mailing Address - Fax:
Practice Address - Street 1:2504 ARDMORE ST SE STE 202A
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-4901
Practice Address - Country:US
Practice Address - Phone:810-588-4236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-15
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012971101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor