Provider Demographics
NPI:1073156998
Name:CHRISTMAN, MICHELE ERNST (LPC, MS)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:ERNST
Last Name:CHRISTMAN
Suffix:
Gender:F
Credentials:LPC, MS
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:ERNST
Other - Last Name:CALICOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 COMMUNITY
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MO
Mailing Address - Zip Code:64735-8804
Mailing Address - Country:US
Mailing Address - Phone:660-885-8131
Mailing Address - Fax:
Practice Address - Street 1:1905 STADIUM BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-1961
Practice Address - Country:US
Practice Address - Phone:888-403-1071
Practice Address - Fax:573-636-3428
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019039860101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional