Provider Demographics
NPI:1205209830
Name:VERLEE, MICHAEL (MA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:VERLEE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W2574 COUNTY ROAD ES
Mailing Address - Street 2:
Mailing Address - City:EAST TROY
Mailing Address - State:WI
Mailing Address - Zip Code:53120-2558
Mailing Address - Country:US
Mailing Address - Phone:262-581-6881
Mailing Address - Fax:
Practice Address - Street 1:W2574 COUNTY ROAD ES
Practice Address - Street 2:
Practice Address - City:EAST TROY
Practice Address - State:WI
Practice Address - Zip Code:53120-2558
Practice Address - Country:US
Practice Address - Phone:262-581-6881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003385A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health