MEDICARE: STACIE MICHALAK LPC

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	101YM0800X	Mental Health Counselor	640103987	MI

General Provider Information

NPI Number	:	1942548029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACIE MICHALAK LPC

Provider Business Mailing Address
First Line	:	46864 FOX RUN DR
Second Line	:
City	:	MACOMB
State	:	MI
Zip	:	48044-3465
Country	:	US
Telephone Number	:	586-994-5682
Fax Number	:

Provider Business Practice Location Address
First Line	:	43329 SCHOENHERR RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48313-1959
Country	:	US
Telephone Number	:	248-777-5353
Fax Number	:	586-792-3061

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

Provider Enumeration Date	:	01/23/2013
Last Update Date	:	09/05/2025

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