Healthcare Provider Details

I. General information

NPI: 1285772525
Provider Name (Legal Business Name): MICHELLE M STEPHAN MS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MICHELLE M BRATEL

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 E MAIN ST
CARSON CITY MI
48811-9741
US

IV. Provider business mailing address

419 E MAIN ST
CARSON CITY MI
48811-9741
US

V. Phone/Fax

Practice location:
  • Phone: 616-745-3494
  • Fax: 616-327-4090
Mailing address:
  • Phone: 616-202-5052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401013235
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401013235
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: