Provider Demographics
NPI:1043371552
Name:SPANO, MICHELLE ANNE (MA, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ANNE
Last Name:SPANO
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 UNION ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1348
Mailing Address - Country:US
Mailing Address - Phone:781-268-2200
Mailing Address - Fax:
Practice Address - Street 1:270 UNION ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1348
Practice Address - Country:US
Practice Address - Phone:781-268-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6713101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health