Provider Demographics
NPI:1346337656
Name:HOUSTON, MICHAEL ANTON (LCSW , LMSW, RAS)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANTON
Last Name:HOUSTON
Suffix:
Gender:M
Credentials:LCSW , LMSW, RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 LAGUNA BLVD STE 112-107
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-4151
Mailing Address - Country:US
Mailing Address - Phone:916-271-5464
Mailing Address - Fax:
Practice Address - Street 1:2830 G ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3784
Practice Address - Country:US
Practice Address - Phone:916-500-4828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAH0504101828101YA0400X
CA101YA0400X
MI6801083726101YM0800X
MD101YP1600X
CALCS 281971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral