Provider Demographics
NPI:1548239965
Name:FIORE, MICHELE THERESA (LPC)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:THERESA
Last Name:FIORE
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 1:4032 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-2940
Mailing Address - Country:US
Mailing Address - Phone:814-942-4354
Mailing Address - Fax:
Practice Address - Street 1:310 PENN ST
Practice Address - Street 2:STE202
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-2044
Practice Address - Country:US
Practice Address - Phone:814-941-8411
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000440101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1437580Medicare UPIN
PA7205389Medicare UPIN