Provider Demographics
NPI:1497076020
Name:HOWARD, MICHELE (MED CADC, MISA II)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MED CADC, MISA II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 W 55TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60632-4242
Mailing Address - Country:US
Mailing Address - Phone:312-747-1020
Mailing Address - Fax:312-747-8671
Practice Address - Street 1:4150 W 55TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632-4242
Practice Address - Country:US
Practice Address - Phone:312-747-1020
Practice Address - Fax:312-747-8671
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health