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General NPI Number Information
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NPI Number | 1689127920
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Entity Type | Individual
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Provider Name | BRYAN JACOB MICHALOWSKI LCSWA
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Gender | Male
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Dates
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Enumeration Date | 08/03/2016
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 322 8TH AVE E
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City | HENDERSONVILLE
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State | NC
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Zip | 28792-3713
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Country | US
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Telephone | 828-708-7088
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Fax | 828-800-9326
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Provider Business Mailing Address
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Address Line | 200 RIVER MILL DR APT 307
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City | ASHEVILLE
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State | NC
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Zip | 28803-0423
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Country | US
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Telephone | 734-395-3202
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P017023
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License Number State | NC
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