Provider Demographics
NPI:1346380615
Name:KEARBY, MICHELLE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:KEARBY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5850 TOWN AND COUNTRY BLVD
Mailing Address - Street 2:STE #1201
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6942
Mailing Address - Country:US
Mailing Address - Phone:469-236-9795
Mailing Address - Fax:214-705-1149
Practice Address - Street 1:5850 TOWN AND COUNTRY BLVD
Practice Address - Street 2:STE #1201
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6942
Practice Address - Country:US
Practice Address - Phone:469-236-9795
Practice Address - Fax:214-705-1149
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19800101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist