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General NPI Number Information
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NPI Number | 1881823078
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Entity Type | Individual
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Provider Name | MICHELLE LEIGH SHAMBO LPCC, LMHC
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Gender | Female
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 01/08/2017
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Provider Practice Location Address
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Address Line | 44 OSAGE CIR
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City | BISHOP
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State | CA
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Zip | 93514-7466
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Country | US
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Telephone | 360-266-0778
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Fax | 360-748-4762
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Provider Business Mailing Address
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Address Line | 44 OSAGE CIR
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City | BISHOP
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State | CA
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Zip | 93514-7466
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Country | US
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Telephone | 760-873-8980
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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 | LH60017481
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC 407
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License Number State | CA
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