Provider Demographics
NPI:1417735838
Name:MICHALSKI, EMILY NICOLE (MS, LCAT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:NICOLE
Last Name:MICHALSKI
Suffix:
Gender:F
Credentials:MS, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 OXFORD ST APT 504
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-2142
Mailing Address - Country:US
Mailing Address - Phone:757-848-6389
Mailing Address - Fax:
Practice Address - Street 1:267 OXFORD ST APT 504
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-2142
Practice Address - Country:US
Practice Address - Phone:757-848-6389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY002777221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health