MEDICARE: MR. BRENT WILLIAM MICHAUD

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	CP60944835	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598286791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRENT WILLIAM MICHAUD

Provider Business Mailing Address
First Line	:	PO BOX 2394
Second Line	:
City	:	LONGVIEW
State	:	WA
Zip	:	98632
Country	:	US
Telephone Number	:	360-200-5419
Fax Number	:	360-200-6736

Provider Business Practice Location Address
First Line	:	1616 S. GOLD ST. #4
Second Line	:
City	:	CENTRALIA
State	:	WA
Zip	:	98531-0001
Country	:	US
Telephone Number	:	360-807-4929
Fax Number	:	360-807-4160

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

Provider Enumeration Date	:	06/28/2017
Last Update Date	:	10/30/2020

Similar Medicare Providers

1831629476 — CHAD ERIC HOLMES CO60709269
Practice Location Address:

1616 S. GOLD ST. #4
CENTRALIA, WA
98531-0001

Practice Phone: 360-807-4929
Practice Fax: 360-807-4160

1043707078 — ELSIE PEREZ MORIN
Practice Location Address:

1616 S GOLD ST #4
CENTRALIA, WA
98531-0001

Practice Phone: 360-807-4929
Practice Fax: 360-807-4160

1679050181 — MORGAN ROBBINS LINDBERGH
Practice Location Address:

1616 S GOLD ST STE 4
CENTRALIA, WA
98531-0001

Practice Phone: 360-807-4929
Practice Fax: 360-807-4160

1235608449 — ASHLEY REYNVANN
Practice Location Address:

1616 S. GOLD ST. #4
CENTRALIA, WA
98531-0001

Practice Phone: 360-807-4929
Practice Fax: 360-807-4160

1942497789 — MRS. SARA ELLEN CARRILLO MSW, LICSW,MHP
Practice Location Address:

CHILD AND FAMILY BEHAVIORAL HEALTH SERVICES , 9040 JACKSON AVE
TACOMA, WA
98531-0001

Practice Phone: 253-968-4843
Practice Fax:

1780688671 — PHYSICIAN SERVICES CORPORATION OF SOUTHERN ILLINOIS INC
Practice Location Address:

1441 W BROADWAY
CENTRALIA, IL
62801-0001

Practice Phone: 618-532-9050
Practice Fax:

Directions to “ MR. BRENT WILLIAM MICHAUD ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.