Provider Demographics
NPI:1407942642
Name:CANFIELD, MICHELLE STERN (PHD, LMFT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:STERN
Last Name:CANFIELD
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14715 BEL RED RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3940
Mailing Address - Country:US
Mailing Address - Phone:425-467-1234
Mailing Address - Fax:206-350-8460
Practice Address - Street 1:14715 BEL RED RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3940
Practice Address - Country:US
Practice Address - Phone:425-467-1234
Practice Address - Fax:206-350-8460
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002259106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist