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General NPI Number Information
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NPI Number | 1700687431
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Entity Type | Individual
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Provider Name | MICHELLE SONG LAPC, MS.ED
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Gender | Female
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 1518 WALNUT ST STE 1100
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3406
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Country | US
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Telephone | 410-608-0066
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Fax |
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Provider Business Mailing Address
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Address Line | 1524 SOUTH ST UNIT 605
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City | PHILADELPHIA
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State | PA
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Zip | 19146-1636
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Country | US
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Telephone | 551-250-6098
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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 | APC000823
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License Number State | PA
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