MEDICARE: RACHEL J MICHAUD

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	MC10670	ME
2	1041C0700X	Clinical Social Worker	LC12287	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962627539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL J MICHAUD

Provider Business Mailing Address
First Line	:	11 W MAIN ST
Second Line	:	STE 103
City	:	FORT KENT
State	:	ME
Zip	:	04743-1250
Country	:	US
Telephone Number	:	207-834-5430
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 MARKET ST
Second Line	:
City	:	FORT KENT
State	:	ME
Zip	:	04743-1418
Country	:	US
Telephone Number	:	207-834-5430
Fax Number	:

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

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	06/12/2019

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Directions to “ RACHEL J MICHAUD ” Practice Location

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