Provider Demographics
NPI:1073766754
Name:HARRING, MICHELLE L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:L
Last Name:HARRING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SHELLY
Other - Middle Name:
Other - Last Name:HARRING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15301 WARREN SHINGLE RD
Mailing Address - Street 2:
Mailing Address - City:BEALE AFB
Mailing Address - State:CA
Mailing Address - Zip Code:95903-1907
Mailing Address - Country:US
Mailing Address - Phone:909-904-6216
Mailing Address - Fax:
Practice Address - Street 1:15301 WARREN SHINGLE RD
Practice Address - Street 2:
Practice Address - City:BEALE AFB
Practice Address - State:CA
Practice Address - Zip Code:95903-1907
Practice Address - Country:US
Practice Address - Phone:909-904-6216
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS221951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical