Provider Demographics
NPI:1326565730
Name:SOWARDS, MICHELLE LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:SOWARDS
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 1:2976 STONE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:VA
Mailing Address - Zip Code:23153-2245
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3058 RIVER RD W
Practice Address - Street 2:
Practice Address - City:GOOCHLAND
Practice Address - State:VA
Practice Address - Zip Code:23063-3202
Practice Address - Country:US
Practice Address - Phone:804-556-5400
Practice Address - Fax:804-556-5403
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007238101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional