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NPI Code Detail

MEDICARE: MICHAEL RICHARD PRIESING MHW CATC

MEDICARE: MICHAEL RICHARD PRIESING MHW CATC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1558623363
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL RICHARD PRIESING MHW CATC
Provider Business Mailing Address
First Line : 17011 BEACH BLVD STE 900
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92647-5998
Country : US
Telephone Number : 949-300-1657
Fax Number :
Provider Business Practice Location Address
First Line : 17011 BEACH BLVD STE 900
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92647-5998
Country : US
Telephone Number : 949-300-1657
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2012
Last Update Date : 07/21/2022

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