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General NPI Number Information
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NPI Number | 1457992026
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Entity Type | Individual
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Provider Name | MICHELLE LYNNE SPILLANE LPC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2019
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Last Update Date | 10/03/2019
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Provider Practice Location Address
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Address Line | 221 NEW BRIDGE ST
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City | JACKSONVILLE
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State | NC
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Zip | 28540-4736
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Country | US
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Telephone | 910-378-7676
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Fax |
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Provider Business Mailing Address
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Address Line | 1403 HAMMOCK BEACH RD
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City | SWANSBORO
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State | NC
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Zip | 28584-9522
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Country | US
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Telephone | 850-221-3060
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Fax |
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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 | 13435
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License Number State | NC
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