Provider Demographics
NPI:1164093233
Name:PRETZ, MICHAEL (LPC, CRC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:PRETZ
Suffix:
Gender:M
Credentials:LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5964 HILLYER CT
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-4515
Mailing Address - Country:US
Mailing Address - Phone:360-472-1675
Mailing Address - Fax:
Practice Address - Street 1:3268 N INSPIRATION LOOP
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-1250
Practice Address - Country:US
Practice Address - Phone:360-472-1675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK178744101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional