Provider Demographics
NPI:1235656885
Name:ROWAN, MICHELLE L (MA, LPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:ROWAN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9501 N CAPITAL OF TEXAS HWY STE 104
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-7254
Mailing Address - Country:US
Mailing Address - Phone:214-618-8402
Mailing Address - Fax:972-534-1595
Practice Address - Street 1:9501 N CAPITAL OF TEXAS HWY STE 104
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-7254
Practice Address - Country:US
Practice Address - Phone:214-618-8402
Practice Address - Fax:972-534-1595
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1800908101YM0800X
OHC.1600462-TRNE390200000X
TX80836101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program