Healthcare Provider Details

I. General information

NPI: 1841523503
Provider Name (Legal Business Name): MICHELLE N BADGER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE N BADGER LPC

II. Dates (important events)

Enumeration Date: 09/14/2009
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37200 N GANTZEL RD STE 200
SAN TAN VALLEY AZ
85140-7385
US

IV. Provider business mailing address

37200 N GANTZEL RD STE 200
SAN TAN VALLEY AZ
85140-7385
US

V. Phone/Fax

Practice location:
  • Phone: 480-405-3514
  • Fax:
Mailing address:
  • Phone: 480-405-3514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-21961
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00293700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: