MEDICARE: MICHELLE POWER 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	4263	MA

General Provider Information

NPI Number	:	1598933178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE POWER LMHC

Provider Business Mailing Address
First Line	:	453A LAKE AVENUE
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01604-1366
Country	:	US
Telephone Number	:	774-696-0203
Fax Number	:

Provider Business Practice Location Address
First Line	:	453A LAKE AVENUE
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01604-1366
Country	:	US
Telephone Number	:	774-696-0203
Fax Number	:

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

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	02/15/2008

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