Provider Demographics
NPI:1730416546
Name:PIERCE, MICHELE (LCSW-C)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200B ISLAND PROFESSIONAL PARK
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21666-4030
Mailing Address - Country:US
Mailing Address - Phone:443-615-1934
Mailing Address - Fax:
Practice Address - Street 1:200B ISLAND PROFESSIONAL PARK
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21666-4030
Practice Address - Country:US
Practice Address - Phone:436-151-9344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14316101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional