Provider Demographics
NPI:1467471664
Name:LAWSON, MICHELLE L (HSP-PA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:LAWSON
Suffix:
Gender:F
Credentials:HSP-PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 WESTCHESTER DRIVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2536
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:1208 EASTCHESTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3170
Practice Address - Country:US
Practice Address - Phone:336-802-2536
Practice Address - Fax:336-802-2534
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2506103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6107385Medicaid