Provider Demographics
NPI:1497008171
Name:TROYER, MICHELLE CHARLENE (LCSW, MSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CHARLENE
Last Name:TROYER
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 W BUTTERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-7042
Mailing Address - Country:US
Mailing Address - Phone:417-343-9118
Mailing Address - Fax:
Practice Address - Street 1:1831 W MELVILLE RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-1675
Practice Address - Country:US
Practice Address - Phone:417-890-5533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040318611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical