Provider Demographics
NPI:1437395811
Name:MICHAUD, TESSA DARLENE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TESSA
Middle Name:DARLENE
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 HAWK POINTE DR
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-3152
Mailing Address - Country:US
Mailing Address - Phone:314-960-2766
Mailing Address - Fax:
Practice Address - Street 1:1809 HAWK POINTE DR
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-3152
Practice Address - Country:US
Practice Address - Phone:314-960-2766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20080239531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical