Provider Demographics
NPI:1225586456
Name:TAFT WEBB, MICHELLE KIMBERLY I (MA, LCPC, NCC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:KIMBERLY
Last Name:TAFT WEBB
Suffix:I
Gender:F
Credentials:MA, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9844 CYPRESSWOOD DR APT 1106
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-3854
Mailing Address - Country:US
Mailing Address - Phone:443-626-4244
Mailing Address - Fax:
Practice Address - Street 1:9844 CYPRESSWOOD DR APT 1106
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-3854
Practice Address - Country:US
Practice Address - Phone:443-626-4244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-16
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81002101YM0800X
MDLGP6083101YM0800X, 101YP2500X
MDLC7559101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional