MEDICARE: KATY BRIANNA MICHAELS MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	112080	CA

General Provider Information

NPI Number	:	1043605686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATY BRIANNA MICHAELS MSW

Provider Business Mailing Address
First Line	:	77725 MICHIGAN DR APT 3
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-8065
Country	:	US
Telephone Number	:	760-883-9097
Fax Number	:

Provider Business Practice Location Address
First Line	:	2825 E TAHQUITZ CANYON WAY STE B202
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-6995
Country	:	US
Telephone Number	:	760-883-9097
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2015
Last Update Date	:	06/01/2025

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