Provider Demographics
NPI:1225384845
Name:HITCHCOCK, MICHELLE ELIZABETH (LPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:HITCHCOCK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 PARK CIRCLE DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-7628
Mailing Address - Country:US
Mailing Address - Phone:601-664-0455
Mailing Address - Fax:601-664-1675
Practice Address - Street 1:200 PARK CIRCLE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7628
Practice Address - Country:US
Practice Address - Phone:601-664-0455
Practice Address - Fax:601-664-1675
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MS1862101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health