Provider Demographics
NPI:1548606809
Name:BAYS, MICHELLE ANNETTE (LICDC)
Entity Type:Individual
Prefix:PROF
First Name:MICHELLE
Middle Name:ANNETTE
Last Name:BAYS
Suffix:
Gender:F
Credentials:LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 JOSEPHINE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-1114
Mailing Address - Country:US
Mailing Address - Phone:614-893-8506
Mailing Address - Fax:
Practice Address - Street 1:511 INDUSTRIAL MILE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-2412
Practice Address - Country:US
Practice Address - Phone:614-275-2077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH121039101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)