Healthcare Provider Details

I. General information

NPI: 1780094516
Provider Name (Legal Business Name): MICHELLE BARRON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 09/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 N MAIN ST
CHELSEA MI
48118-1370
US

IV. Provider business mailing address

350 N MAIN ST
CHELSEA MI
48118-1370
US

V. Phone/Fax

Practice location:
  • Phone: 734-593-5267
  • Fax:
Mailing address:
  • Phone: 734-593-5267
  • Fax: 734-593-5255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801093936
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: