Provider Demographics
NPI:1376606806
Name:NAULT, MICHELLE R (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:R
Last Name:NAULT
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 1:2700 CORPORATE DR STE 200
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2733
Mailing Address - Country:US
Mailing Address - Phone:205-314-4761
Mailing Address - Fax:205-314-4701
Practice Address - Street 1:2700 CORPORATE DR STE 200
Practice Address - Street 2:SUITE 102
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-2733
Practice Address - Country:US
Practice Address - Phone:205-314-4761
Practice Address - Fax:205-314-4701
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2761101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional