Healthcare Provider Details

I. General information

NPI: 1740316892
Provider Name (Legal Business Name): MICHELLE LYNN DEAN MA, ATR-BC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2007
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2129 18TH ST. SOUTH
BIRMINGHAM AL
35209
US

IV. Provider business mailing address

2810 N CHURCH ST
WILMINGTON DE
19802-4447
US

V. Phone/Fax

Practice location:
  • Phone: 215-421-2942
  • Fax:
Mailing address:
  • Phone: 215-421-2942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC001025
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC05222
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: