MEDICARE: DR. MICHELLE LEE DAVIS LPC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1275273013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE LEE DAVIS LPC

Provider Business Mailing Address
First Line	:	6234 ACROPOLIS DR SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-7102
Country	:	US
Telephone Number	:	616-450-3990
Fax Number	:

Provider Business Practice Location Address
First Line	:	6234 ACROPOLIS DR SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-7102
Country	:	US
Telephone Number	:	616-450-3990
Fax Number	:

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

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	06/17/2024

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Directions to “ DR. MICHELLE LEE DAVIS LPC” Practice Location

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