Provider Demographics
NPI:1437397270
Name:NASON, MICHELLE R (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:R
Last Name:NASON
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 W STATE ROAD 434
Mailing Address - Street 2:UNIT 101
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-5019
Mailing Address - Country:US
Mailing Address - Phone:407-310-9625
Mailing Address - Fax:
Practice Address - Street 1:2139 W STATE ROAD 434
Practice Address - Street 2:UNIT 101
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-5019
Practice Address - Country:US
Practice Address - Phone:407-310-9625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9572101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health