MEDICARE: MS. MICHELLE ANN HOULE MS, MLADC LCMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	1262	NH
2	101YM0800X	Mental Health Counselor	4690	NH

General Provider Information

NPI Number	:	1255090536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE ANN HOULE MS, MLADC LCMHC

Provider Business Mailing Address
First Line	:	3A CHURCH ST
Second Line	:
City	:	ROCHESTER
State	:	NH
Zip	:	03839-5201
Country	:	US
Telephone Number	:	603-366-8559
Fax Number	:

Provider Business Practice Location Address
First Line	:	3A CHURCH ST
Second Line	:
City	:	ROCHESTER
State	:	NH
Zip	:	03839-5201
Country	:	US
Telephone Number	:	603-366-8559
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2021
Last Update Date	:	08/13/2024

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