Healthcare Provider Details

I. General information

NPI: 1952312423
Provider Name (Legal Business Name): CHRISTINE M MICHAUD LMHC, LCPC, NCC, DCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDDAC BAVARIA UNIT 28037
APO AE
09112-8037
US

IV. Provider business mailing address

USA MEDDAC BAVARIA CMR 411 BLDG 700
APO AE
09112
US

V. Phone/Fax

Practice location:
  • Phone: 941-421-2915
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2382
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7927
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: