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General NPI Number Information
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NPI Number | 1992648760
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Entity Type | Individual
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Provider Name | MICHELLE RUPP LPC
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Gender | Female
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Dates
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Enumeration Date | 04/14/2026
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Last Update Date | 04/14/2026
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Provider Practice Location Address
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Address Line | 51424 VAN DYKE AVE STE 23
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-4409
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Country | US
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Telephone | 586-215-6534
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Fax | 586-218-3158
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Provider Business Mailing Address
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Address Line | 5618 KINGFISHER LN
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City | CLARKSTON
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State | MI
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Zip | 48346-2937
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Country | US
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Telephone | 248-229-6186
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401008638
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License Number State | MI
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