Provider Demographics
NPI:1437575206
Name:WHITE, MICHELE (PHD LLP LPC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:PHD LLP LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 PACKARD ST STE 270
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-5008
Mailing Address - Country:US
Mailing Address - Phone:734-995-6755
Mailing Address - Fax:734-557-3995
Practice Address - Street 1:3840 PACKARD ST STE 270
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-5008
Practice Address - Country:US
Practice Address - Phone:734-995-6755
Practice Address - Fax:734-557-3995
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-17
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009991103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral