MEDICARE: MRS. MICHELLE RUPP LPC

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	101YP2500X	Professional Counselor	6401008638	MI

General Provider Information

NPI Number	:	1992648760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE RUPP LPC

Provider Business Mailing Address
First Line	:	5618 KINGFISHER LN
Second Line	:
City	:	CLARKSTON
State	:	MI
Zip	:	48346-2937
Country	:	US
Telephone Number	:	248-229-6186
Fax Number	:

Provider Business Practice Location Address
First Line	:	51424 VAN DYKE AVE STE 23
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48316-4409
Country	:	US
Telephone Number	:	586-215-6534
Fax Number	:	586-218-3158

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

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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