Provider Demographics
NPI:1013557891
Name:HARRAST, MICHELLE (LLPC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:HARRAST
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 E GAYLORD ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-3632
Mailing Address - Country:US
Mailing Address - Phone:989-513-2311
Mailing Address - Fax:
Practice Address - Street 1:724 E SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1900
Practice Address - Country:US
Practice Address - Phone:989-796-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401018061101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health