Healthcare Provider Details

I. General information

NPI: 1154237105
Provider Name (Legal Business Name): MICHELLE CARA MIRKES MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21131 GARDEN LN
FERNDALE MI
48220-4200
US

IV. Provider business mailing address

21131 GARDEN LN
FERNDALE MI
48220-4200
US

V. Phone/Fax

Practice location:
  • Phone: 248-586-8900
  • Fax: 248-586-8882
Mailing address:
  • Phone: 248-586-8900
  • Fax: 248-586-8882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberSC0000263
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401018115
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: