Provider Demographics
NPI:1427392430
Name:KERY, MICHELLE K (LPCMH)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:K
Last Name:KERY
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7334
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-0334
Mailing Address - Country:US
Mailing Address - Phone:302-494-3078
Mailing Address - Fax:
Practice Address - Street 1:2405 ALLENDALE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-5225
Practice Address - Country:US
Practice Address - Phone:302-494-3078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC - 0000585101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional