Provider Demographics
NPI:1497302517
Name:DOYLE, MICHELLE BROOKE (LPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:BROOKE
Last Name:DOYLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 EAGLE BROOK LN
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-2642
Mailing Address - Country:US
Mailing Address - Phone:512-970-2244
Mailing Address - Fax:
Practice Address - Street 1:8700 MANCHACA RD STE 703
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5378
Practice Address - Country:US
Practice Address - Phone:512-270-1513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73803101YM0800X, 1041C0700X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical