Provider Demographics
NPI:1124197579
Name:SJOLINDER, MICHELLE (LCP & CSOTP)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:SJOLINDER
Suffix:
Gender:F
Credentials:LCP & CSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10908 COURTHOUSE RD STE 102225
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-2658
Mailing Address - Country:US
Mailing Address - Phone:703-732-3411
Mailing Address - Fax:
Practice Address - Street 1:10908 COURTHOUSE RD STE 102225
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-2658
Practice Address - Country:US
Practice Address - Phone:703-732-3411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004146103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical