MEDICARE: MS. MICHELLE LURIE LMHC

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	MH 9881	FL

General Provider Information

NPI Number	:	1568786275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE LURIE LMHC

Provider Business Mailing Address
First Line	:	3944 SAN SIMEON LN
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331-5059
Country	:	US
Telephone Number	:	954-647-6523
Fax Number	:

Provider Business Practice Location Address
First Line	:	1750 N UNIVERSITY DR
Second Line	:	SUITE 201
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-8903
Country	:	US
Telephone Number	:	954-755-8247
Fax Number	:

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

Provider Enumeration Date	:	03/24/2010
Last Update Date	:	03/24/2010

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