Healthcare Provider Details

I. General information

NPI: 1427525757
Provider Name (Legal Business Name): MICHELLE LYNN TRUPIANO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE LYNN KRASON LPC

II. Dates (important events)

Enumeration Date: 10/24/2018
Last Update Date: 10/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

882 OAKMAN BLVD
DETROIT MI
48238-3710
US

IV. Provider business mailing address

2038 ATLAS DR
TROY MI
48083-2663
US

V. Phone/Fax

Practice location:
  • Phone: 313-961-4890
  • Fax:
Mailing address:
  • Phone: 586-843-8382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401015088
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: