Provider Demographics
NPI:1437444502
Name:HEPWORTH, MICHELLE PARKIN (MAC, LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:PARKIN
Last Name:HEPWORTH
Suffix:
Gender:F
Credentials:MAC, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-1316
Mailing Address - Country:US
Mailing Address - Phone:817-876-9824
Mailing Address - Fax:972-242-2932
Practice Address - Street 1:1100 W JACKSON RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-1316
Practice Address - Country:US
Practice Address - Phone:817-876-9824
Practice Address - Fax:972-242-2932
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201635106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist