MEDICARE: MICHELLE ST. AMAND GUNSCHEL M.ED.

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1285839225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE ST. AMAND GUNSCHEL M.ED.

Provider Business Mailing Address
First Line	:	99 SUMMER ST
Second Line	:	6TH FLOOR
City	:	BOSTON
State	:	MA
Zip	:	02110-1213
Country	:	US
Telephone Number	:	617-587-1500
Fax Number	:	617-587-1577

Provider Business Practice Location Address
First Line	:	9 8TH ST
Second Line	:
City	:	NEW BEDFORD
State	:	MA
Zip	:	02740-6027
Country	:	US
Telephone Number	:	508-990-0418
Fax Number	:	508-979-4580

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

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	10/10/2007

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