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General NPI Number Information
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NPI Number | 1124419718
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Entity Type | Individual
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Provider Name | ANGELA L MICHELS LMHC
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Gender | Female
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Dates
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Enumeration Date | 02/18/2015
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Last Update Date | 02/06/2018
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Provider Practice Location Address
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Address Line | 1890 S. 14TH ST. #302
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034
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Country | US
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Telephone | 904-557-8618
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Fax | 888-463-2798
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Provider Business Mailing Address
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Address Line | 1890 S. 14TH ST #302
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034
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Country | US
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Telephone | 904-557-8618
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Fax | 888-463-2798
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH 12732
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License Number State | FL
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